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Form of workAthens Position Details
Position Title:Claims Examiner II – General Liability
Department: Liability Claims
Reports To: Claims Supervisor
FLSA Status: Non-Exempt
Job Grade: 11
ATHENS ADMINISTRATORSSince our founding in 1976, Athens Administrators has been a recognized leader in third-party claims administration services. However, more important than what we do is how we do it. Athens employees provide service that translates into real and lasting benefits—every single day! With offices throughout the United States, Athens Administrators offers Workers’ Compensation, Property & Casualty, Managed Care and Program Business solutions. Athens is proud to be a third-generation family-owned company and is dedicated to its core values of honesty and integrity, a commitment to service and results, and a caring family culture. We are so proud that our employees have consistently voted Athens as a Best Place to Work!
POSITION SUMMARYAthens Administrators has an immediate need for a Claims Examiner II – General Liability to support a school district account for our P&C department. This individual must reside in Southern California in order to attend file reviews and meetings in Ventura County throughout the year. This position does allow for work from home as long as technical requirements are met. The Claims Examiner II – General Liability candidate will be responsible for the review, analysis and process of low to moderate claims within assigned authority limits and consistent with good faith handling practices. These claims are typically mid-level exposure and are associated with schools governed under Joint Power Authority regulation. Claims will entail handling some litigation and coverage issues, as well as new claim matters. The goal of the position is to ensure the delivery of quality service to customers while protecting their interests.
PRIMARY RESPONSIBILITIESOur new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned:
Advanced knowledge in the following areas: 1) claims handling concepts, practices and techniques specific to CA Joint Power Authority government code and regulation, , 2) functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated advanced analytical, decision making and negotiation skills.
- Must have the experience and ability to organize and effectively manage a caseload of School/JPA takeover claims and new loss assignments venued in CA.
- Investigate, evaluate and determine settlement value or denial of liability for low to moderate level General Liability claims
- Within prescribed settlement authority for line of business, establish appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Make recommendations to set reserves at appropriate levels for claims outside of authority level
- Will handle premise liability and due process and procedures, such as Individual Education Plans (IEP)
- Prepare comprehensive reports as required. Identify and communicate specific claim trends and account and/or policy issues to management
- Manage the litigation process through the retention of counsel. Adhere to the line of business litigation guidelines to include reporting, budget, bill review and payment
- Document and manage claims (i.e.: record statements, update diaries, write reports) from inception to closure
- Ensure appropriateness of all payments
- Coordinate and work with external vendor services to effectively analyze and evaluate exposures on each claim.
- Capability to adjust Multi-Exposure General Liability claims for both Bodily Injury and Property Damage.
- Facilitate between claimants, clients, advisors, board member representatives, administrators, and attorneys in resolution of liability claims
- Gather and exchange information with clients, claimants, insurance brokers, inspectors, producers, and account managers
- Lead and conduct comprehensive file reviews and case analysis discussions with legal representatives and officials for the account, as well as brokers and major case unit managers
- Attend meetings and educational seminars for professional development
- Conduct on-sight or frequent quarterly claim reviews with the client representatives, as required.
The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations.
- High School Diploma or equivalent (GED) required for all positions
- AA/AS or BA/BS preferred but not required
- Possesses a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX, or FL preferred
- Additional State Adjuster License(s), specifically a California designation, may be required within 180 days
- Maintain licenses and continuing education requirements in all states.
- Relies on extensive experience and judgment to plan and accomplish goals in a fast-paced environment
- Minimum of 5 years of General Liability handling experience
- Experience with relevant CA insurance laws, codes, and procedures
- Ability to physically attend roughly 8 – 10 meetings in Agoura Hills annually
- Proficiency in investigation and resolution of low to moderate school/JPA claims
- Familiarity and understanding of the handling standards and requirements of schools, including but not limited to premise liability and due process and procedures, such as Individual Education Plans (IEP) and educators/administrators.
- Strong negotiation skills and ability to achieve optimal settlement results for clients
- Understanding of premise liability and risk transfer concepts
- Ability to follow instruction and communicate with key clients on critical issues
- Well-developed and advanced verbal and written communication skills and attention to detail
- Strong attention to detail and the ability to research and resolve problems
- Negotiation skills
- Excellent organizational skills and ability to multi-task
- Ability to type quickly, accurately and for prolonged periods
- Proficient in Microsoft Office Suite
- Ability to learn additional computer programs
- Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues and make appropriate recommendations and solutions for resolution
- Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization
We look forward to learning about YOU! To be considered, please submit your resume and application directly through our website at http://www.athensadmin.com/careers/job-openings/ Feel free to include a cover letter if you’d like to share any other details. All applications received are reviewed by our in-house Corporate Recruiter.
This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training.
Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.
THANK YOU!We look forward to reviewing your information. Applying for jobs isn’t necessarily fun, but we promise we are. Don’t forget to check out our website at www.athensadmin.com as well as our LinkedIn, Glassdoor, and Facebook pages!
Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. Further information about our comprehensive benefits package may be found on our website at https://www.athensadmin.com/careers/why-work-here
