Claims Examiner I California FAIR Plan Association - Los Angeles, CA 90010 $55,592 - $67,384 a year - Full-time, Contract Position Summary Oversees the investigation of insurance claims for property or commercial losses based on coverage, appraisal, and verifiable damage. Interacts with independent adjusters and policyholders to oversee the review of claim forms and other records to determine insurance coverage and that payment recommendations and settlements have been made in accordance with company practices, procedures, and Fair Claims Settlement Practices regulations. This positon will report to the VP of Claims and will be an integral part of the Claims team. Specific Duties and Responsibilities: * Adjust reserves and provide reserve recommendations to ensure reserving activities are consistent with company policies. * Confer with Vice President of Claims and legal counsel on claims involving litigation. * Enter claim transactions, such as payments, reserves, notes, and other documentation in a clear and concise manner. * Examine claims investigated by independent adjusters, including further investigation of questionable claims to determine payment authorization. * Investigate, evaluate, and adjust claims, applying technical knowledge and human relations skills to promote fair and prompt settlement of claims. * Conduct daily diary reviews on claim files to insure status letters are sent to policyholders timely and in accordance with Department of Insurance regulations. * Pay and process claims within designated authority level. * Supervise independent adjusters to ensure they have followed CFP IA Guidelines. * Verify and analyze data used in settling claims to ensure validity and that settlement is in accordance with company practices and procedures. General Duties of Position: * Understanding of fraudulent and illegal practices. * Maintains compliance with the Department of Insurance and Company procedures. * Reviews reports submitted by independent adjusters, verifies coverage, and authorizes timely payments to policyholders * Reviews independent adjuster's correspondences to policyholders for accuracy and completeness. Communicates to adjusters and/or others involved to secure missing information. * Promptly negotiates settlements, making sure that the settlement reflects the actual insured losses while ascertaining that the insurer is protected from invalid claims. * The individual in this position must meet the following general requirements: * Knowledge and Skills: * Minimum Bachelors degree or equivalent preferred. * Excellent oral and written communication skills. * Working experience with MS-Office (especially Word and Excel) is required. * 2 to 5 years property claims experience and excellent customer service. * Comprehensive understanding of policy contract/statutes and claims processes. * Certified in CEA and Fair Claims Settlement Practices. Job Type: Full-time Salary: $55,592.00 to $67,384.00 /year Experience: * Property claims: 2 years Education: * Bachelor's Location: * Los Angeles, CA 90010 License: * California Earthquake Authority * Fair Claims Settlement Practices Regulations 6 hours ago - save job