Allied American USA is Hiring a Commercial Property Damage Desk Examiner (NY Adjuster License Required)

We are currently seeking an experienced Commercial Property Damage Desk Examiner interested in a full-time or project based, remote position to join our TPA Department. 

Our ideal candidate is an expert in handling full claim assignments in a TPA environment for first party damage claims, with expertise in commercial buildings and golf courses, including litigation. Candidates should have strong negotiation skills and be proficient in complying with standards, managing expectations, supporting client specific protocols, and fulfilling management directives. Five or more years as a desk examiner in a TPA environment, and Commercial Property Damage experience is required.An active NY Adjuster License is required. **Auto, workers compensation and trucking will not be considered in the experience requirements.

Responsibilities: Investigate and settle semi-complex/complex claims promptly and equitably under minimal supervision. Advanced knowledge of insurance policies with emphasis first party property damages. Interprets and makes decisions using independent judgment on more complex and unusual policy coverages and determines if coverages apply to claims submitted. Analyzes claims activity and prepares reports for clients/carriers and management. Uses independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost-effective manner and ensuring timely issuance of disbursements. Strong negotiation skills and experience with public adjusters, attorneys and other insurance providers of service.

Additional functions:

• Strong analytical and problem-solving ability to conduct, coordinate and direct investigations into loss facts and extent of first-party damages
• Extensive knowledge of commercial policy coverages
• Determine coverage, experience with drafting Reservation of Rights letters and coverage Disclaimers and be able to articulate coverage
•  Interview customers, claimants, and witnesses; determine liability and prepare evaluation of bodily injury claim based on injuries
• Negotiate with claimants and attorneys to resolve claims
• Knowledge of litigation, mediations, trial prep and direction of defense counsel
• Submits closure to manager or client for review and approval, as necessary
• Review claims assigned for indicators of SIU or Underwriting referrals throughout  life of claim; escalate as soon as any indicators are identified
• Write up referrals as appropriate
• Notify manager for joint file reviews as defined for manager referral
• Maintain complete, pertinent journal for each case throughout life of case
• Maintain up to date diary for all claims
• Answer phone calls, voicemails and emails within 24 hours

Requirements

• Bachelor’s Degree, and more than 5 years specialized experience including Liability and Litigation
• 5+ years desk examination experience in a TPA environment (auto, workers compensation, and trucking will not be considered)
• Experience reviewing and quality checking field adjusters' preliminary and final reports; coverage analysis, and damage evaluation
• Coverage/contract knowledge with adherence to insurance regulations; Strong analytical and     problem-solving ability.
• Possess an active NY Adjuster license, home state adjuster license, plus active state licenses per client requirements
• Possesses excellent written and oral communication skills, time management and organizational skills, and customer service skills
• High level of competency with computer technology: email, Word, Excel, etc.

‍