Disability Claims Examiner, Sr. jobs in Summerville, SC

The ideal claims team member will be an analytical and creative problem solver with the ability to hone in on key issues for coverage, liability and damage evaluation. Our claim examiners are assertive decision makers with a strong desire to persuade through negotiation and conflict management. The claims team offers on going challenges, even for the most experienced professional, as every claim is unique, providing new opportunities to learn and grow. We welcome our ongoing interaction with underwriting, compliance and actuarial to keep our products healthy.

Essential Functions:

Coverage is confirmed by reviewing the first notice of loss, checking all available systems, and interpreting policy language. Upon coverage analysis, the examiner prepares initial position letters to the policyholder such as disclaimers and reservation of rights. Once coverage is confirmed, the examiner conducts a thorough and focused investigation of the claim using independent adjusters, and other experts, as appropriate. Investigation includes securing all pertinent facts, statements & documents, and reviewing and approving repair estimates. Initial reserves are posted, reviewed and maintained as file develops to properly reflect ultimate exposure based upon coverage and damage evaluation. The claims examiner is responsible for proactive file management toward final disposition via an effective diary, direction to coverage counsel & independent adjusters, analysis & strategy leading to claims settlement. Substantive and timely file documentation in the Company’s claim system should reflect file activity. While the claim is pending, communication includes delivery of comprehensive and concise authority requests, reinsurance reports, coverage position letters and appropriate communication with underwriting.

Other Duties and Responsibilities:

In addition to the essential functions, an examiner is expected to support customer service by responding the same day to phone and email both internally and externally and adhere to established claim service promises. The position may entail completion of special projects. There is an expectation for enrollment in continuing education to maintain state licenses and to support both professional and personal development as outlined in the annual Individual Development Plan. Occasional travel requirements may be required.

Specific Skills:

Strong oral and written communication skills, insightful analytical skills, effective negotiation skills, strong organizational and time management skills, technical knowledge of insurance coverage, and claim evaluation.

Minimum Job Requirements:

We are seeking 3 years (Associate Claim Examiner) or 7 years (Claim Examiner) of relevant experience handling first party property claims including prior examiner, adjuster, paralegal, attorney/lawyer and/or other transferable experience.

At USLI, our goal is to strengthen our community and culture by representing all races, genders, religions and sexual orientations. We continue to move conversations about diversity, equity and inclusion forward to ensure every community member has a sense of belonging, a voice and a seat at the table.

USLI provides full-time community members with a comprehensive benefits package, access to wellness programs, continuing education resources, and multiple opportunities to get involved with charitable organizations.