Job Description

Job Details: Level: Experienced,

Job Location: Involuntary Remote - ALL STATES - Remote All States, CA 90802,

Position Type: Full Time, Education Level: High School,

Salary Range: $80,000.00 - $90,000.00 Salary/year,

Travel Percentage: None,

Job Shift: Day,

Job Category: Admin - Clerical, This is a fully remote position. This is a full-time floater position.

Must have an active FL, NY, GA or TX license

Position Summary

Under minimal supervision, investigates, evaluates, and resolves complex commercial automobile and general liability claims, including matters in litigation. Reviews policy provisions, endorsements, and applicable vehicle schedules to determine coverage and assess liability, damages, and potential exposure. Communicates reserve and settlement recommendations to clients and maintains effective working relationships with claimants, legal representatives, counsel, and other involved parties.

Serves in a float capacity, providing claims handling coverage during planned paid time off, unexpected absences, and extended leaves of absence. Assumes responsibility for assigned files to maintain timely claim activity, prevent backlogs, and meet client service level agreements.

DUTIES AND RESPONSIBILITIES

The Claims Examiner (Float) is a versatile role designed to ensure continuity of operations within the claims department. This individual provides seamless coverage for permanent examiners during planned Paid Time Off (PTO), unexpected absences, or extended leaves of absence. The primary goal is to prevent backlogs claim and maintain service level agreements (SLAs) regardless of staffing fluctuations.

• Investigates, evaluates, manages, and resolves complex commercial automobile and general liability claims, including litigated claims, in accordance with applicable requirements, client instructions, company procedures, and industry best practices.
• Reviews and interprets insurance policies, endorsements, and vehicle schedules to determine applicable coverage and identify coverage issues.
• Provides temporary coverage for other claims examiners, reviewing transferred files, identifying outstanding activities and deadlines, and maintaining continuity of claim handling.
• Maintains an accurate claim diary and completes timely follow-up on investigations, correspondence, litigation activities, and other required actions.
• Evaluates liability, damages, and potential exposure; recommends appropriate reserves and updates recommendations as additional information becomes available.
• Develops and communicates claim resolution and settlement strategies to clients; negotiates settlements within delegated authority and obtains approval when required.
• Coordinates and directs outside investigators and other service providers; works with clients and counsel to advance claims toward resolution.
• Monitors litigation developments, evaluates counsel’s recommendations, and communicates material changes affecting claim exposure or resolution.
• Prepares loss reports containing a thorough analysis of coverage, liability, damages, reserves, and recommended next steps.
• Identifies potential subrogation and risk transfer opportunities and initiates recovery efforts at the client’s direction.
• Maintains complete, accurate, and timely claim file documentation, including correspondence, reports, discussions, decisions, and supporting rationale.
• Provides responsive, professional service to clients and other involved parties.
• Coordinates file handoffs with supervisors and returning examiners, documenting current claim status, pending actions, and upcoming deadlines.
• Assist supervisors and the claims department with special projects and other assigned responsibilities.
• Performs other duties as assigned.

Position is remote/working from home.

Qualifications: QUALIFICATIONS REQUIRED: Education/Experience: High School Diploma or GED required; bachelor’s degree in related field (preferred) and a minimum of seven+ (7) years’ commercial auto and general liability casualty related experience; or equivalent combination of advanced education and experience.

Special Requirements

• At least 10 years of Commercial Automobile and General Liability claims experience required
• Knowledge of claims handling concepts, practices, and techniques, including but not limited to coverage issues and product line knowledge.
• Demonstrated verbal and written communications skills.
• Demonstrated advanced analytical, decision-making and negotiation skills.
• Computer proficiency.

Knowledge, Skills, and Abilities

• Advanced knowledge of commercial automobile and general liability claims handling, including coverage analysis, investigations, liability evaluation, damages assessment, reserving, and settlement practices.
• Understanding of the litigation process and claim valuation across multiple jurisdictions.
• Strong analytical, problem-solving, decision-making, and negotiation skills.
• Ability to independently manage complex claims within established authority and with minimal supervision.
• Strong written and verbal communication skills, including the ability to prepare clear, thorough claim reports and recommendations.
• Ability to develop and maintain effective relationships with clients, claimants, legal representatives, counsel, and service providers.
• Strong organizational and time management skills, with the ability to prioritize competing assignments and meet deadlines.
• Flexibility to assume unfamiliar claim inventories, assess immediate priorities, and maintain service standards during staffing changes.
• Proficiency with claims management systems, computer applications, and related technology.
• Demonstrated commitment to responsive client service and accurate claim documentation.

Licensing Requirements

• Holds an applicable resident or designated home state adjuster license and required nonresident licenses, or has the ability to obtain required licenses through reciprocity or applicable state examinations.
• Maintains required licenses and completes applicable continuing education requirements.

PREFERRED QUALIFICATIONS

• Bachelor’s degree in a related field.
• Associate in Claims (AIC) and/or Chartered Property Casualty Underwriter (CPCU) designation.
• Experience providing float coverage or managing claims across multiple client accounts and jurisdictions.

Mental and Physical Requirements: [see separate attachment for a copy of checklist of mental and physical requirements]

• MENTAL AND PHYSICAL REQUIREMENTS
• 1. MENTAL EFFORT
• a. Reasoning development:
• Follow one- or two-step instructions; routine, repetitive task.
• Carry out detailed but uninvolved written or verbal instructions; deal with a few concrete variables.
• Follow written, verbal, or diagrammatic instructions; several concrete variables.
• Solve practical problems; variety of variables with limited standardization; interpret instructions.
• X Logical or scientific thinking to solve problems; several abstract and concrete variables.
• Wide range of intellectual and practical problems; comprehend most obscure concepts.
• b. Mathematical development:
• Simple additional and subtraction; copying figures, counting, and recording.
• Add, subtract, multiply, and divide whole numbers.
• X Arithmetic calculations involving fractions, decimals, and percentages.
• Arithmetic, algebraic, and geometric calculations.
• Advanced mathematical and statistical techniques such as calculus, factor analysis, and probability determination.
• Highly complex mathematical and statistical techniques such as calculus, factor analysis, and probability determination; require theoretical application.
• c. Language development:
• Ability to understand and follow verbal or demonstrated instructions; write identifying information; request supplies verbally or in writing.
• Ability to file, post, and mail materials; copy data from one record to another; interview to obtain basic information such as age, occupation, and number of children; guide people and provide basic direction.
• Ability to transcribe dictation; make appointments and process mail; write form letters or routine correspondence; interpret written work instructions; interview job applicants.
• Ability to compose original correspondence, follow technical manuals, and have increased contact with people.
• X Ability to report, write, or edit articles for publication; prepare deeds, contracts or leases, prepare and deliver lectures; interview, counsel, or advise people; evaluate technical data.
• 2. PHYSICAL EFFORT
• a. Physical activity required to perform the job:
• X Sedentary work: Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally, and all other sedentary criteria are met.
• Light work:
• a. Exerting up to 20 pounds of force occasionally
• b. Exerting up to 10 pounds frequently
• c. Exerting a negligible amount of force constantly to move objects
• (If the use of arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most of the time, the job is rated for Light Work).
• Medium work:
• a. Exerting up to 50 pounds of force occasionally
• b. Exerting up to 20 pounds of force frequently
• c. Exerting up to 10 pounds of force constantly to move objects
• Heavy work:
• a. Exerting up to 100 pounds of force occasionally
• b. Exerting up to 50 pounds of force frequently
• c. Exerting up to 20 pounds of force constantly to move objects
• Very heavy work:
• a. Exerting in excess of 100 pounds of force occasionally
• b. Exerting in excess of 50 pounds of force constantly to move objects
• c. Exerting in excess of 20 pounds of force constantly to move objects
• Visual requirements necessary to perform the job:
• Far vision: clarity of vision at 20 feet or more
• X Near vision: clarity of vision at 20 inches or less
• X Mid-range vision: clarity of vision at distances of more than 20 inches and less than 20 feet
• Depth perception: the ability to judge distance and space relationships, so as to see objects where and as they actually are
• Color vision: ability to identify and distinguish colors
• Field of vision: ability to observe an area up or down or to the right or left while eyes are fixed on a given point
• 2. PHYSICAL EFFORT (cont.)
• FREQUENCY
• c. Physical activity necessary to perform the job and frequency (e.g., continually, frequently, or occasionally):
• Climbing: Ascending or descending ladders, stairs, scaffolding, ramps, poles, and the like, using feet and legs and/or hands and arms. Body agility is emphasized. This factor is important if the amount and kind of climbing required exceeds that required for ordinary locomotion.
• Balancing: Maintaining body equilibrium to prevent falling when walking, standing, or crouching on narrow, slippery, or erratically moving surfaces. This factor is important if the amount and kind of balancing exceeds that needed for ordinary locomotion and maintenance of body equilibrium.
• Stooping: Bending body downward and forward by bending spine at the waist. This factor is important if it occurs to a considerable degree and requires full use of the lower extremities and back muscles.
• Kneeling: Bending legs at knee to come to a rest on knee or knees.
• Crouching: Bending the body downward and forward by bending legs and spine.
• Crawling: Moving about on hands and knees or hands and feet.
• Reaching: Extending hand(s) and arm(s) in any direction.
• Standing: Particularly for sustained periods of time.
• Walking: Moving about on foot to accomplish tasks, particularly for long distances.
• Pushing: Using upper extremities top press against something with steady force in order to thrust forward, downward, or outward.
• Pulling: Using the upper extremities to extend force in order to drag, haul, or tug objects in a sustained motion.
• Foot
• Motion: Using feet to push pedals.
• Lifting: Raising objects from a lower to a higher position or moving objects horizontally from position to position. This factor is important if it occurs to a considerable degree and requires substantial use of the upper extremities and back muscles.
• X Fingering: Picking, pinching, typing, or otherwise working with fingers rather than with the whole hand or arm as in handling.
• X Grasping: Applying pressure to an object with the fingers and palm.
• Frequently
• Occasionally
• 2. PHYSICAL EFFORT (cont.)
• FREQUENCY
• X Talking: Expressing or exchanging ideas by means of the spoken word. Those activities in which workers must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly.
• X Hearing: Perceiving the nature of sounds with or without correction. Ability to receive detailed information through verbal communication and to make fine discriminations in sound, such as when making find adjustments on machined parts.
• Feeling: Perceiving attributes of objects, such as size, shape, temperature, or texture by touching with skin, particularly that of fingertips.
• X Repetitive Substantial movements (motions) of the wrists, hands,
• Motion: and/or fingers.
• Frequently
• Frequently
• Frequently
• 3. WORKING CONDITIONS
• Disagreeable job conditions to which the employee may be exposed and the frequency (e.g., continually, frequently, or occasionally) of this exposure.
• WORKING CONDITION
• ENVIRONMENTAL
• FACTOR
• NATURE/REASON
• OF EXPOSURE
• FREQUENCY
• Dirt/Dust
• Noise
• Temperature extremes
• Dampness
• Vibrations
• Equipment movement hazard
• Chemicals/solvents
• Electrical shock
• Significant work pace/pressure
• Odors/Fumes
• Other (specify):