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Expert Complex Claims Examiner
Expert Complex Claims ExaminerKemper • Cerritos, CA, US
Expert Complex Claims Examiner

Expert Complex Claims Examiner

Kemper • Cerritos, CA, US
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Expert Complex Claims Examiner

Kemper is seeking an Expert Complex Claims Examiner. In this position, you will supervise and direct the handling of reporting files of a high level of complexity and / or severity including issuing instructions to other Company personnel to properly handle all aspects of claims referred as per current Best Practices / departmental guidelines. Accountable for handling and control of all claims matters assigned including investigation, evaluation, disposition, reserve accuracy and diary maintenance.

Position Responsibilities :

  • Reviews and analyses Home Office Referral files to identify critical issues relating to the claim and form an appropriate action plan for the handling of the claim. Directs Company personnel to perform specific tasks needed to effectively complete all aspects of the action plan. On-going analysis and reassessment of action plans to ensure achievement of desired results.
  • Analyzes and directs handling of coverage positions and directs activities needed to confirm or deny coverage. Conduct, coordinate and direct investigation into facts of the loss and nature / extent of the damages and / or injuries. Ensures that all documentation of all damages is obtained as required based on the nature of the claim.
  • Evaluates information on contractual coverage, liability and damages, including expert surveys and reports, to determine the extent of exposure to the insured.
  • Ensures documentation of investigation, evaluation, strategies and resolutions of claims are made through reports, file notes, correspondence, memos and other means of communication.
  • Reviews and sets reserves within authority or recommends appropriate reserve changes outside of personal authority to higher management for approval.
  • Ensures that claims are concluded by communicating contractual coverage and liability positions and directs negotiation, arbitration, mediation and other methods of settlement as appropriate to each claim. Directs others to obtain necessary settlement documents including releases, proofs of loss, etc. and directs the issuance of payments.

Position Qualifications :

  • 4+ years of claim handling experience and demonstrated proficiency in analyzing and handling claims including bodily injury claim evaluation and methods of negotiation.
  • Must maintain current adjuster licenses in assigned states.
  • Excellent written and verbal communication skills.
  • Ability to provide technical directions and work effectively with staff at all levels.
  • Must have basic ability to set up and maintain Excel for communication, reporting and documentation purposes.
  • Work is subject to rigid deadlines for handling and reporting and involves the potential for significant human and monetary impact. If not handled appropriately could subject the company to significant losses.
  • Travel may be required on a limited basis.
  • This is a hybrid position reporting to the Cerritos, CA or Henderson, NV office. Possible remote position if not near the office.
  • The range for this position is Hiring Range $68,000.00 to $113,400.00. When determining candidate offers, we consider experience, skills, education, certifications, and geographic location among other factors. This job is also eligible for our Kemper benefits package (Medical, Dental, Vision, PTO, 401k, etc.).

    Kemper is proud to be an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, disability status or any other status protected by the laws or regulations in the locations where we operate. We are committed to supporting diversity and equality across our organization and we work diligently to maintain a workplace free from discrimination.

    Kemper does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Kemper and Kemper will not be obligated to pay a placement fee.

    Kemper will never request personal information, such as your social security number or banking information, via text or email. Additionally, Kemper does not use external messaging applications like WireApp or Skype to communicate with candidates. If you receive such a message, delete it.

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    Examiner • Cerritos, CA, US

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