Claims Examiner - Auto

CanadaRemoteFull-timemid

Finance & AccountingClaims Adjuster

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Quick Summary

Requirements Summary

At least five years of claims management experience, or an equivalent combination of education and experience. In-depth knowledge of personal and commercial auto insurance policies, coverage,

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Finance & AccountingClaims Adjuster

This role is responsible for managing complex personal and commercial auto insurance claims, from initial investigation through to resolution. You will review policy coverage, assess liability, evaluate damages, and ensure that each claim is handled accurately and efficiently. The position involves working on bodily injury and litigated claims, coordinating with independent adjusters and other vendors, and communicating with insured parties, clients, and brokers. You will also identify recovery opportunities and ensure regulatory deadlines and service expectations are met. This is an opportunity to apply advanced claims expertise in a collaborative, service-focused environment while contributing to quality and timely outcomes.

Manage complex personal and commercial auto claims, including bodily injury cases, ensuring files are accurately documented and correctly coded.
Review insurance coverage, investigate claims, determine liability, and evaluate the extent of damages.
Oversee the litigation process for claims that proceed to legal action.
Coordinate vendor activity, including engaging independent adjusters to support claim investigations.
Report significant claims to excess insurers when required.
Develop and maintain action plans to meet regulatory contact deadlines and move claims toward timely, appropriate resolution.
Identify and pursue subrogation and risk transfer opportunities, including securing and disposing of salvage.
Communicate claim decisions, actions, and progress to insured parties, clients, agents, and brokers as appropriate.
Support quality assurance programs and perform additional duties as assigned.
Travel when required.

Requirements

~1 min read

At least five years of claims management experience, or an equivalent combination of education and experience.
In-depth knowledge of personal and commercial auto insurance policies, coverage, claims principles, and applicable laws.
Bachelor’s degree from an accredited college or university preferred.
Relevant professional certification preferred, depending on the line of business.
Ability to obtain and maintain the adjusting licenses required for the position.
Knowledge of medical terminology relevant to claim evaluation and Medicare compliance.
Understanding of deductibles, sub-limits, self-insured retentions (SIRs), carrier programs, and large-deductible programs.
Strong written and verbal communication skills, including presentation and negotiation abilities.
Proficiency with computers and Microsoft Office applications.
Excellent organizational and interpersonal skills, with strong attention to detail.
Ability to collaborate effectively within a team and manage complex claims independently.
Commitment to meeting or exceeding service expectations.