Claims Examiner III Location Hybrid remote in Richmond, VA : The Claims Examiner III investigates and processes self-insured General Liability claims, Commonwealth of Virginia Plan General Liability and Auto Liability claims, and insured Property and Casualty claims for all lines, including property, employment practices liability (EPL), and cyber liability. This job may handle low complexity self-insured Workers' Compensation claims for VCUHS employees contingent upon the needs of VCUHS. This job assists in the coordination of an effective commercial insurance and self-insured General Liability, Auto Liability, and Workers' Compensation Claim Program that is compliant with state laws and that meets the needs of VCUHS. This job is responsible for handling assigned claims appropriately and in a timely and fair manner. This job maintains effective communication with employees, supervisors, VCUHS General Counsel, vendors, brokers, independent adjusters, outside counsel, claims adjusters, opposing attorneys, and all other internal and external stakeholders as appropriate. The job manages medium to high complexity claims with a total dollar value between $4 million to $6 million dollars. Licensure, Certification, or Registration Requirements for Hire: N/A Licensure, Certification, or Registration Requirements for continued employment: N/A
Experience REQUIRED: Minimum of four (4) years of progressively more responsible claims adjudication experience in general liability, auto liability, property, employment practices liability, cyber liability and/or other casualty lines. Previous experience with Microsoft Office applications (Word, Excel, etc.)
Experience PREFERRED: Five (5) years of progressive claim handling expertise to include experience managing indemnity cases, many with complex or high potential subrogation and/or legal issues. Previous work experience in risk management or legal setting.
Education/training REQUIRED: High School diploma or equivalent.
Education/training PREFERRED: Associate's or Bachelor's Degree in Business, Finance or closely related field from an accredited program.
Independent action(s) required: Determines acceptance and/or compensability of claims; including the investigation, evaluation and settlement of claims; establishment of reasonable reserves; authorization of payments within authority; and development of recommendations to the department Director and/or senior management. Coordinates litigation management.
Supervisory responsibilities (if applicable): Provides lead oversight to Claims Examiners I and II and office personnel when asked by the Department Director.
Additional position requirements: Outside of normal office hours, in the event that an employee sustains a work-related fatality or serious injury requiring hospitalization or an incident causing significant property or casualty damage occurs, if available (reachable by phone or online), it is expected that this job will provide oversight and claim assistance as needed, which may include returning to the affected site and/or coordinating with broker, independent adjuster, claim staff, other VCUHS staff, and/or emergency personnel from a remote location.
Age Specific groups served: All
Physical Requirements (includes use of assistance devices as appropriate): Physical Lifting 20-50 lbs. Activities: Prolonged sitting, Walking (distance), Repetitive motion Mental/Sensory: Strong recall, Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical thinking Emotional: Fast pace environment, Able to handle multiple priorities, Frequent and intense customer interactions, Able to adapt to frequent change
Position is hybrid (3 days/week in office on site, 2 days/week remote). Candidate should have insurance experience handling auto liability and general liability claims. Experience handling workers' comp claims a plus but not required.
Workday Day (United States of America) EEO Employer/Disabled/Protected Veteran/41 CFR 60-1.4.
