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Open Position: Claim Examiner

Job Title: Claim Examiner

Department: Claims

FLSA Status: Exempt

Position Reports to: Claim Supervisor

Summary:

The Commercial Claim Supervisor oversees a team of claims professionals responsible for managing and resolving commercial insurance claims, with a specialized focus on educational institutions. This leadership role ensures operational excellence, regulatory compliance, and high-quality service delivery across all phases of the claims lifecycle. The Supervisor provides technical guidance, monitors performance metrics, and fosters a collaborative, accountable team culture.

This position requires strong leadership, advanced claims expertise, and the ability to navigate complex stakeholder relationships, particularly within academic environments.

Essential Functions and Responsibilities:

  1. Complex Claim Investigation & Evaluation
    • Independently confirm coverage and conduct in-depth investigations of high-exposure liability claims.
    • Analyze multi-party liability scenarios and assess legal and financial exposure.
    • Collaborate with internal and external legal counsel, technical experts, and consultants.
  2. Strategic Claim Management
    • Manage a caseload of complex and litigated claims with minimal supervision.
    • Utilize advanced claim systems and analytics to monitor trends and identify emerging risks.
    • Ensure timely and accurate documentation and compliance with internal and external standards.
  3. Stakeholder Communication & Litigation Support
    • Serve as the primary contact for high-profile or sensitive liability claims involving educational institutions.
    • Communicate effectively with insureds, attorneys, agents, and internal leadership.
    • Participate in mediations, depositions, and settlement conferences as needed.
  4. Coverage & Damage Assessment
    • Interpret complex policy language, exclusions, and endorsements to determine coverage applicability.
    • Oversee damage assessments and liability evaluations using internal tools and external resources.
    • Provide strategic recommendations for claim resolution and risk mitigation.
  5. Reserving, Negotiation & Settlement
    • Establish and maintain accurate reserves for complex liability claims.
    • Lead negotiations for settlements, balancing legal exposure, fairness, and cost-effectiveness.
    • Ensure all claim activities are documented in accordance with regulatory and audit standards.

Knowledge, Skills, and Abilities:

  • Juris Doctorate (JD) strongly preferred; advanced certifications (e.g., AIC, CPCU) a plus.
  • Minimum 5 years of experience in commercial liability claims, including litigation management.
  • Experience working with public school entities or educational institutions is highly desirable.
  • Deep understanding of tort law, insurance coverage, and state-specific regulations.
  • Exceptional written and verbal communication skills.
  • Strong analytical, negotiation, and decision-making abilities.
  • Proficiency in Microsoft Office Suite and claim administration software.
  • Ability to work independently and manage a high-complexity desk.
  • Occasional travel required for field inspections, mediations, or client meetings.

Hours: Full-time, EST
Compensation:
$97,000 – $150,000
Location: Cortland, NY / Long Island, NY or Remote within New York state