Claims Examiner

  • Company: Adecco
  • Posted: December 09, 2016
  • Reference ID: 1124758496
SUMMARY: Investigate third party homeowner property insurance claims to determine the extent of the
company¿s liability. Experience of greater than 12 month period, and capable of independent claim
examination with minimal supervision.

DUTIES AND RESPONSIBILITIES: The following reflects management¿s definition of essential
functions for this job but does not restrict the tasks that may be assigned. Management may assign or reassign
duties and responsibilities to this job at any time due to reasonable accommodation or other reasons.
Duties for this position include:
¿¿Works without direct supervision.
¿¿This is an intermediate position and is a progression of examination job leading to a more senior
examiner position.
¿¿Should have an Adjusters License.
¿¿The ability to work with escalated claims and able to fully complete a claim filing from beginning to
total completion.
¿¿Provide exceptional customer service to policy holders
¿¿Verbal and written communication with policy holders, agents, attorneys, contractors,
independent field adjusters, consultants, law enforcement, public adjusters, etc.
¿¿Timely initiate, conduct, and complete an objective investigation into the case facts,
coverage, claimed damages, and causation/legal liability on all claims
¿¿Verification and detailed analysis of applicable policy/endorsement contract language in
comparison to case facts
¿¿Assess damages
¿¿Evaluate, document and substantiate each aspect of the claim, including damage to
structures, damage to personal property, and loss of use
¿¿Ensure reserves reflect potential exposure based upon preliminary factual development
and ensure timely reserve changes are posted based upon investigative findings
¿¿Retain and manage service providers
¿¿Expense management
¿¿Ensure compliance with company and state regulations


¿¿Bachelor's Degree (BA) from four-year college or university, and one to two years of related
experience and/or training, or equivalent combination of education and experience.
¿¿Ability to read and interpret documents such as safety rules, operating and maintenance instructions,
and procedure manuals. Ability to write routine reports and correspondence. Ability to speak
effectively before groups of customers or employees of the organization.
¿¿Ability to add, subtracts, multiply and divide all units of measure, using whole numbers, common
fractions and decimals. Ability to compute rate, ration and percent and to draw and interpret bar
¿¿Ability to define problems, collect data, establish facts and draw valid conclusions. Ability to interpret
and extensive variety of technical instructions in mathematical or diagram form and deal with several
abstract and concrete variables.
¿¿Proficient on database, spreadsheet, and internet software, project management and word processing
¿¿Excellent customer service skills.
¿¿Excellent verbal and written communication skills.
¿¿Strong organizational skills; able to manage priorities and workflow.
¿¿Must be able to speak, read, write, and understand the primary language(s) used in the workplace.
¿¿Acute attention to detail.
¿¿Versatility, flexibility, and a willingness to work within constantly changing priorities with enthusiasm.

¿¿Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes
information skillfully; Develops alternative solutions; Works well in group problem solving situations;
Uses reason even when dealing with emotional topics.
¿¿Project Management - Develops project plans; Coordinates projects; Communicates changes and
progress; Completes projects on time and budget; Manages project team activities.
¿¿Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and
gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in
¿¿Written Communication - Writes clearly and informatively; Edits work for spelling and grammar;
Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret
written information.
¿¿Customer Service - Manages difficult or emotional customer situations; Responds promptly to
customer needs; Solicits customer feedback to improve service; Responds to requests for service and
assistance; Meets commitments.
¿¿Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with
integrity and ethically; Upholds organizational values.

While performing the duties of this job, the employee is regularly required to stand; walk; sit; use hands to
finger, handle, or feel; reach with hands and arms; and talk or hear. The employee must regularly lift and/or
move up to 5 pounds, occasionally up to 10 pounds.
The job may involve working outside normal business hours, or outside the scope of the Licensing Analyst
position, depending on skills and business needs.

WORK ENVIRONMENT: The work environment characteristics described here are representative of
those an employee encounters while performing the essential functions of this job. Reasonable
accommodations may be made to enable individuals with disabilities to perform the essential functions.
The noise level in the work environment is usually moderate.
REPORTING RELATIONSHIP: Reports directly to Claims Manager and or Claims Supervisor.

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