Claims Examiner, Sr. jobs in New Haven, CT

Position Overview:

The Claims Examiner is responsible for property claims in the areas of investigation, evaluation, reserving, negotiation, and resolution of the companies’ claims in multiple jurisdictions. The position is required to follow established claims management standards and exercise solid judgment when solving business problems; using critical thinking and decision-making skills and judgment within his/her assigned authority levels. The Claims Examiner continually explores ways to apply claim’s best practices to business challenges.

Essential Functions:

• Timely and effectively investigate and evaluate claims while managing outside adjusters and legal counsel
• Clearly and succinctly document files and prepare reports in timely manner
• Directs settlement activity using investigative and problem-solving skills in direct negotiations
• Handle all assigned cases efficiently and cost-effectively through conclusion
• Analyze and recommend appropriate reserves; periodically reviewing and adjusting these reserves based on the assessment of probable liability, financial responsibility and exposure
• Thoroughly review, analyze, and interpret coverage in accordance with applicable policies
• Level of authority and complexity of decision making established by departmental management team
• Create and manage positive working relationships with internal and external business partners
• Review invoices, estimates, and other documents to ensure accuracy and legitimacy prior to payment
• Prepare and communicate written status reports, for policyholders, management and business partners, including treaty and facultative reinsurers, agents and brokers

Knowledge, Skills, Abilities:

• Presents a positive and professional image of the companies
• Knowledge and commitment to company mission, vision, and organizational values
• Ability to quickly assimilate and practically utilize new information
• Possess written and verbal communications skills required to review, understand, interpret, and convey data including medical records and legal documents, and coverage interpretation
• Strong customer service skills including interacting with internal and external customers
• Team player; works effectively as part of a team

Job Requirements:

Required:

• High School Diploma
• Bachelor’s degree in Business Management, Insurance, or related field; or equivalent work experience
• 3 years of progressive property claims handling experience
• All lines property/casualty adjuster’s license
• Experience analyzing and interpreting coverage at a level commensurate with complexity of assigned claims
• Experience preparing and communicating written status reports to various parties
• Understands current relevant case law and statutory law in multiple jurisdictions
• Experience implementing compliance processes and procedures to ensure consistent, efficient and effective compliance with all federal, state, local and filed requirements
• Knowledge of insurance operations

Preferred:

• Five years of progressive property claims handling experience
• AIC designation
• Auto claims handling experience
• Knows the Public and Affordable Housing business

Work environment & Physical Demands

• Inside climate-controlled office building
• Ability to lift 25lbs
• <10% Travel
• Prolonged sitting and using a PC
• Must be legally authorized to work in the United States without need for sponsorship now or at any time in the future

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Department Overview

The HAI Group®[1], Claims Department provides expertise and guidance to HAI Group members and insureds. We partner with our constituents to solve complex problems and facilitate favorable solutions. The team has deep subject matter expertise on the claims process and its financial impact to the insurance business and our insureds’ business. Our goal is to achieve excellence using conceptual and critical thinking to serve the customer and add value to the partnership. We collaborate with our members and insureds to make the most appropriate business decisions that assure timely, fair and favorable resolution of claims. The team works closely with all other departments within HAI Group’s insurance operation to coordinate a high level of service to our members and insureds.

Company Overview

HAI Group is the nation’s leading property-casualty insurance company founded by and dedicated to affordable housing organizations. While we are recognized as a pioneer of affordable housing insurance programs, insurance is not our only strength. We protect, preserve, and promote the sustainability of affordable housing with an array of products and services that support the challenges housing organizations face. Besides insurance, we offer risk management services, online training, and consulting services used by more than 1,500 housing organizations nationwide. Headquartered in Cheshire, Connecticut, HAI Group® was recognized as a Top Workplace in 2020, 2021 and 2022.

Cultural Objective

HAI Group contributes to a culture that creates a safe and healthy working environment and a space of inclusiveness and belonging for all by exceeding our customers’ expectations, working collaboratively across the organization, embracing diversity, and demonstrating mutual respect and empathy.

HAI Group Benefits and Perks

• Bonus program eligibility
• Annual merit program
• Outstanding 401(k) program and non-elective contribution
• Flexible work schedules
• Generous paid time off, paid volunteer days and paid holidays
• Medical, vision and dental Insurance
• Company paid life, AD&D, short-term disability, and long-term disability coverage
• HSA, FSA and dependent care options
• On-Site wellness: Full gym and locker rooms, wellness initiatives, outdoor basketball and tennis court, picnic pavilion area
• Tuition reimbursement and loan repayment
• Professional development
• Community outreach

(Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions)

HAI Group is an Equal Opportunity Employer.