Claims Examiner
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Job Description
Remote Claims Examiner evaluating, negotiating, and settling complex bodily injury claims for Mercury Insurance. Investigating liability, damages, injuries, and regulatory compliance across multiple states.
Responsibilities:
- Evaluate, negotiate, and settle low to high complexity bodily injury claims
- Prevent unnecessary exposure to the Company and Policyholders
- Conduct complete investigations to determine liability, damages, injuries, and applicability of state laws and regulations
- Negotiate, settle, and authorize payment for complex injury claims with legal counsel and unrepresented parties
- Investigate and analyze medical records, law enforcement reports, and other extensive records
- Conduct witness interviews to determine claim value and set or maintain reserves
- Evaluate liability, venue, opposing counsel, legal risk, anticipated expenses, and other claim-value factors
- Research and respond to customer inquiries and concerns throughout the life of a claim
- Work with medical and technical experts and outside counsel to obtain reports and opinions
- Coordinate settlement, mediation, and arbitration with attorneys for pre-litigation cases
- Handle litigated cases
- Potentially support legal counsel at depositions, mediations, arbitrations, and trials as Company Representative
- Ensure regulatory compliance across multiple states
Requirements:
- High School Diploma or GED
- You may be required to obtain a Company sponsored Adjuster’s license to handle claims, to be secured upon hire
- Prior experience investigating, evaluating, negotiating, and settling moderately to highly complex claims
- Or equivalent combination of education and/or experience
- Thorough knowledge and comprehension of Mercury claims handling policies and procedures
- Analytical assessment of causation and exposure based on complex fact patterns and extensive bodily injuries and property damage
- Excellent written and verbal communication skills
- Critical attention to detail and strong organizational skills
- Ability to plan and control workload time effectively
- Ability to prioritize tasks and switch focus as needed
- Sound judgment in dealing with customers, claimants, and legal counsel
- Ability to assess risk and make qualified decisions
- Conflict resolution and negotiation abilities
- Ability to conduct detailed and complicated investigations
- Ability to collaborate well with others
- Ability to build rapport and demonstrate emotional intelligence
- Self-motivation and accountability while working remotely
- Demonstrated proficiency with MS Office products (Outlook, Word) and claims related software
- Dedicated workspace free from distractions
- Preferred: Bachelor’s Degree
- Preferred: 3+ years related experience
- Preferred: Knowledge of medical and legal terminology, and applicable laws
- Preferred: Ability to improve processes through technology
- Preferred: Knowledge of claims compliance across multiple states
Benefits:
- Competitive compensation
- Flexibility to work from anywhere in the United States for most positions
- Paid time off (vacation time, sick time, 9 paid Company holidays, volunteer hours)
- Incentive bonus programs (potential for holiday bonus, referral bonus, and performance-based bonus)
- Medical, dental, vision, life, and pet insurance
- 401 (k) retirement savings plan with company match
- Engaging work environment
- Promotional opportunities
- Education assistance
- Professional and personal development opportunities
- Company recognition program
- Health and wellbeing resources, including free mental wellbeing therapy/coaching sessions, child and eldercare resources, and more
- Reasonable accommodations for qualified individuals with disabilities
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