Senior Claims Examiner

Résumé du poste

Lead the management of complex property and liability claims within a TPA environment, handling high-exposure losses from first notice to resolution. Provide technical leadership and mentorship to junior claims staff while ensuring operational excellence and regulatory compliance.

Détails du poste

SENIOR CLAIMS EXAMINER Kaufman Claims is seeking a highly experienced Senior Claims Examiner to lead the management of complex property and liability claims within a third-party administrator (TPA) environment. The successful candidate will possess extensive technical expertise in property and liability claims, exceptional coverage analysis capabilities, and a proven ability to independently manage high-exposure and complex losses from first notice through final resolution. KEY RESPONSIBILITIES Claims Management & Technical Leadership Independently manage a portfolio of complex, high-severity, and specialty property and lability claims across Canada. Analyze policy wordings, endorsements, exclusions, and claim circumstances to determine coverage and develop defensible coverage positions. Prepare detailed coverage analyses, reservation of rights letters, declination letters, settlement recommendations, and client reports. Establish and execute effective claim investigation and resolution strategies for complex claims involving significant financial, legal, or reputational exposure. Evaluate liability, causation, damages, business interruption exposures, and loss quantification. Maintain accurate indemnity and expense reserves, ensuring reserve adequacy throughout the claim lifecycle. Develop settlement strategies and negotiate claim resolutions within delegated authority while obtaining client approval when required. Leadership & Mentorship Provide coaching, technical guidance, and mentoring to Claims Examiners and junior claims staff. Act as a subject matter expert for complex property and marine coverage issues. Assist management with file reviews, quality assurance initiatives, training programs, and best practice development. Share technical expertise and industry knowledge to strengthen overall team capability. Operational Excellence Maintain complete, accurate, and audit-ready documentation. Ensure compliance with client service instructions, regulatory requirements, internal procedures, and delegated authorities. Identify trends, emerging risks, and process improvement opportunities. Support claims audits, reporting initiatives, and operational projects. Escalate significant coverage, litigation, regulatory, and large-loss matters appropriately. REQUIRED EXPERIENCE & SKILLS At least 5-7 years of progressively responsible claims examining or adjusting experience, including substantial responsibility for complex property and marine claims. Strong commercial property claims expertise, including large-loss and complex claims management. Advanced knowledge of policy interpretation, coverage analysis, and insurance contract wording. Demonstrated experience operating within insurer, TPA, independent adjusting, or Lloyd's market environments. Proven ability to manage high-exposure claims with minimal supervision. Strong reserve management, negotiation, litigation management, and settlement skills. Exceptional analytical, problem-solving, decision-making, and risk assessment abilities. Excellent written and verbal communication skills with the ability to communicate complex technical issues clearly and effectively. Experience mentoring and supporting junior team members is strongly preferred. Strong organizational skills with the ability to manage multiple competing priorities and deadlines. EDUCATION, CREDENTIALS & TECHNOLOGY Post-secondary education in business, insurance, risk management, law, or a related field, or an equivalent combination of education and experience. CIP designation required. Provincial Adjuster License or the ability to obtain and maintain required licensing. Commitment to ongoing professional development and industry education. Advanced proficiency in Microsoft Office applications and claims management systems. WHY KAUFMAN CLAIMS Join a collaborative and growing specialty claims organization where your expertise directly contributes to client success. As a Senior Claims Examiner, you will have the opportunity to manage challenging and complex claims while helping shape team performance, technical excellence, and client service standards across the organization

Ce que vous ferez

Lead the management of complex property and liability claims within a TPA environment, handling high-exposure losses from first notice to resolution. Provide technical leadership and mentorship to junior claims staff while ensuring operational excellence and regulatory compliance.

Exigences

Requires 5-7 years of experience in complex property and marine claims with a CIP designation and a Provincial Adjuster License. A post-secondary degree in business, insurance, risk management, or law is required or equivalent experience.

Compétences indiquées

• Negotiation · Souhaitée

Autres compétences pertinentes

Relevées dans la description du poste. Confirmez les exigences importantes ci-dessus.

• Claims Management
• Coverage Analysis
• Property Claims
• Liability Claims
• Reserve Management
• Negotiation
• Litigation Management
• Risk Assessment
• Policy Interpretation
• Mentoring
• Technical Leadership
• Loss Quantification
• Business Interruption
• Marine Coverage
• Client Reporting
• Audit Documentation

Domaines d’emploi

• Finance & Accounting
• Legal
• Management & Leadership
• Consulting
• Administrative