Sr Claims Examiner - MSI

Why MSI? We thrive on solving challenges.

As a leading MGA, MSI combines deep underwriting expertise with insurer and reinsurer risk capacity to create specialized insurance solutions that empower distribution partners to meet customers’ unique needs.  

We have a passion for crafting solutions for the important risks facing individuals and businesses. We offer an expanding suite of products – from fully-digital embedded renters coverage to high-value homeowners insurance to sophisticated commercial coverages, such as cyber liability and habitational property – delivered through agents, brokers, wholesalers and other brand partners. 

Our partners and customers count on us to deliver exceptional service through a dedicated team that makes rapid resolutions a priority. We simplify the insurance experience through our advanced technology platform that supports every phase of the policy lifecycle.

Bring on your challenges and let us show you how we build insurance better.

MSI handles third-party claims involving bodily injury and property damage under various homeowner’s insurance policies and renter’s insurance policies nationwide.  We are looking for an experienced individual to join our Liability Claims Team as a Sr. Claims Examiner.   The Sr Claims Examiner is considered an expert in managing insurance claims and will be handling claims with high severity and complexity, both pre-suit and in suit.   The Sr Claims Examiner must have the experience and technical knowledge needed to manage a complex case load from inception to resolution while providing our customers and business partners superior service at all times. The ability to develop relationships and effectively communicate with others is a key factor to succeeding in this role.   Having a strategic vision coupled with tactical execution to achieve results, in accordance with goals and objectives, is also critical to the overall success of this position. The Sr Claims Examiner must be able to work with little to minimal supervision in a fast-paced environment.

PRIMARY RESPONSIBILITIES:

• Directly handles third-party claims involving complex and severe bodily injury or property damage from initial assignment through to resolution of claim, including negotiating settlements.
• Evaluates and analyzes insurance policies in order to make coverage determinations.
• Drafts Reservation of Rights letters and coverage disclaimers as warranted.
• Makes prompt contact with policy holders, claimants and other appropriate parties to gather information, take recorded statements, and conduct thorough investigations.  
• Investigates claims to determine validity and the potential for liability against insureds.
• Evaluates damages (both bodily injuries and property damages) to determine potential exposures and sets appropriate reserves.
• Works a claim load efficiently and independently with little to no supervision.
• Sets timely file reserves in compliance with company’s reserving philosophy and continues to evaluate pending reserves throughout the life of the claim.

• Manage defense counsel which includes assisting in claim strategy, evaluating potential exposure, reviewing invoices, and attending mediations and settlement conferences as necessary.
• Engages experts, as needed, to assist in the evaluation of the claim and monitors experts and vendors’ performance while controlling expense costs.
• Drafts reports for large losses and reports to Leadership as required.
• Evaluates, negotiates and determines settlement values in settlement of claims.
• Communicates with all interested parties throughout the life of the claim including proactively discussing coverage decisions, the need for additional information, and settlement amounts with interested parties.
• Establishes and maintains an organized diary system to ensure all claims are appropriately handled in a timely manner.
• Adheres to all state/local regulations including the NJ/PA Unfair Claims Practices and Guidelines.
• Handles all claims in accordance with Best Practices and provides Best-In-Class customer service to insureds, agents, claimants, and business partners.
• Responsible for monitoring and completing assigned claims inventory.
• Acquires and maintains multiple state adjuster’s licenses and maintains continuing education requirements.
• Develops and maintains relationships with external and internal stakeholders.
• Identifies questionable risks, red flags and fraud indicators and alerts the Special Investigation Unit when applicable.
• Identifies opportunities for subrogation and ensures recovery interests are protected.  
• Acts as a mentor for less experienced Claims Examiners.
• Updates and maintains well drafted claim file notes with proper documentation throughout the life of the file.  
• Assists with special projects when required.

KNOWLEDGE, SKILLS & ABILITIES:

• Ability to communicate clearly, professionally, and provide superior customer service over the phone and through written correspondence.
• Strong organizational and time management skills.
• Strong writing skills.
• Excellent analytical, investigative, and negotiation skills.
• Proficient with Microsoft Office, Teams, Word, Excel and various other computer skills with the ability to learn and utilize new computer systems and other technologies.

EDUCATION & EXPERIENCE:
 

• Bachelor’s degree or equivalent work experience
• 10+ years of casualty claims adjusting experience
• First-Party Property experience is a plus
• Insurance designations preferred
• Must have a State Adjuster License(s) (California, Florida licenses are desirable) with a willingness to expand licenses as needed.

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