Senior Claims Examiner

Accountabilities:

• Investigate and evaluate complex Employment Practices Liability claims, including coverage, liability, and damages, ensuring accurate and timely assessments.
• Establish, document, and execute appropriate claim strategies designed to achieve early, equitable, and cost-effective resolutions.
• Analyze initial claim reports, insurance contracts, legal information, and other technical materials to determine appropriate coverage and claim-handling approaches.
• Represent the organization in meetings with management and business partners and participate virtually in mediations.
• Build and maintain productive relationships with clients, insureds, underwriters, agents, defense counsel, and other internal and external stakeholders.
• Use claims technology and systems effectively to monitor, document, and manage caseloads.
• Maintain compliance with established claims-handling standards relating to investigation, coverage, loss assessment, documentation, and case management.
• Apply sound judgment and creative problem-solving to address complex claims and customer needs.
• Contribute to a collaborative team environment by sharing ideas, demonstrating initiative, and supporting collective goals.
• Assist with training new claims examiners and provide coaching and guidance as they develop their claims-handling capabilities.
• Participate in structured classroom and on-the-job training covering employment law, insurance products, coverage analysis, investigation techniques, legal processes, and settlement negotiation.
• Obtain and maintain applicable resident, designated home state, and potentially additional state adjuster licenses as required.

Requirements:

• Bachelor’s degree required; a Juris Doctor (JD) is preferred but not required.
• 2–4 years of experience handling claims of comparable complexity or working in a legal position.
• Previous Employment Practices Liability (EPL) or Financial Lines experience is preferred.
• Strong verbal and written communication skills, with the ability to clearly explain complex information.
• Strong interpersonal skills and the ability to establish productive relationships with stakeholders at all organizational levels.
• Strong aptitude for evaluating, analyzing, and interpreting technical and financial information.
• Sound decision-making skills and the ability to exercise appropriate judgment when handling complex claims.
• Proven ability to work independently while also contributing effectively within a collaborative team.
• Demonstrated initiative, leadership potential, and commitment to high-quality performance.
• Excellent time management, organizational, and problem-solving skills.
• Ability to adapt quickly to new ideas, situations, technologies, and processes.
• Creative and practical approach to overcoming obstacles and developing solutions to customer and claim-related challenges.
• Willingness to learn and apply employment law, insurance contracts, claims practices, and negotiation techniques.
• Ability to obtain required adjuster licensing if not already licensed.

Benefits:

• Collaborative professional environment with colleagues from diverse backgrounds across claims, legal, human resources, and related disciplines.
• Comprehensive classroom and on-the-job training led by managers, experienced claims examiners, and defense counsel.
• Opportunity to develop specialized expertise in Employment Practices Liability and employment-related legal issues.
• Exposure to complex and evolving workplace claims and insurance matters.
• Opportunities to develop coaching and leadership skills by supporting newer claims professionals.
• Technology-enabled, paperless claims environment.
• Non-remote position based in Pittsburgh, Pennsylvania.
• Opportunities to work with internal and external business partners across multiple functions.