Senior Claims Examiner

HAI Group®[1], a property-casualty insurance company serving the affordable housing industry, is looking for a Senior Claims Examiner who is ready to take the next step in their career. As Senior Claims Examiner at HAI Group, you’ll be rewarded with interesting challenges, competitive incentives/benefits, and a people-focused company culture. Are you ready to become a Senior Claims Examiner on our talented and welcoming Claims team? Learn more about the position and company below and submit your resume today! 

Position Overview

• Execute: The Senior Claims Examiner is responsible for investigation, evaluation, reserving, negotiation and resolution of the companies’ claims in multiple jurisdictions
• Problem Solve: 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 their assigned authority levels. The Senior Claims Examiner Continually explores ways to apply claim’s best practices to business challenges
• Collaborate: Individuals in this role are expected to mentor and coach team members to increase their technical expertise and business contribution.

Skills and Requirements

• Timely and effectively investigate and evaluate claims while managing outside adjusters and legal counsel
• 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
• Handle all assigned cases efficiently and cost-effectively through conclusion, identifying and thoroughly investigating all available risk transfer options (subrogation and third-party recoveries and re-insurance)
• Review, analyze and interpret coverage in accordance with applicable policies
• Prepare coverage evaluations, document files and draft letters for management review in a timely manner
• Concentration on larger cases with reinsurance involvement requiring ability to track aggregates, and prepare more complex reports
• Prepare clear and concise reports with little or no guidance that can be presented for review and require little or no edits by management
• Mentors examiners, as well as coordinators, by providing guidance, sharing expertise, and overseeing work product
• Serve as Subject Matter Expert for certain venues and/or coverage lines
• Create and manage positive working relationships with internal and external business partners
• Presents a positive and professional image of 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 to review, understand, interpret and convey data including medical records, 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

Knowledge/Experience/Licenses

Required: 

• Bachelor’s Degree in Business Management, Insurance, or related field required, or equivalent work experience
• Minimum 5 years progressive claims handling experience for property/casualty insurance company or third-party administrator
• Progressive property casualty claims handling experience
• Ability to analyze and interpret coverage at a level commensurate with complexity of assigned claims
• Ability to prepare and communicate written status reports, for policyholders, management and business partners, including treaty and facultative reinsurers, agents and brokers
• Understands the litigation process, current relevant case law and statutory law in multiple jurisdictions
• Ability to implement compliance processes and procedures to ensure consistent, efficient and effective compliance with all federal, state, local and filed requirements
• Ability to review invoices, estimates, legal fees, and other documents to ensure accuracy and legitimacy prior to payment
• Maintains adjusting licenses in all required states
• Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future.

Preferred: 

• AIC designation
• Knows the Public and Affordable Housing business
• Knowledge of insurance operations

Department Overview

The HAI Group 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

HAI Group is an Equal Opportunity Employer.