Injury Examiner- Section II

As a dedicated Injury Examiner- Section II, you will adjust complex bodily injury claims and UIM claims to include confirming coverage, determining liability, investigating, evaluating, negotiating, defending, and settling claims in compliance with state laws and regulations. You are accountable for delivering a concierge level of best in class member service through setting appropriate expectations, proactive communications, advice, and empathy. This hybrid role requires an individual to be in the office 3 days per week. This position can be based in one of the following locations: San Antonio, TX, Chesapeake, VA or Tampa, FL. Relocation assistance is not available for this position. Work Hours: You would support members in the Eastern or Central time zones. You need to be available to work core business hours for those locations. What you'll do: Adjusts primarily complex homeowner bodily injury claims with significant injuries (e.g. traumatic brain injury, disfigurement, fatality) complex auto claims, UM/UIM, and small business claims, as well as some auto physical damage associated with those claims. Identifies, confirms, and makes coverage decisions on complex claims. Investigates loss details, determines legal liability, evaluates, negotiates, and adjudicates claims appropriately and timely; within appropriate authority guidelines with clear documentation to support accurate outcomes. Prioritizes and manages assigned claims workload to keep members and other involved parties informed and provides timely claims status updates. Collaborates and supports team members to resolve issues and identifies appropriate matters for escalation. Partners and/or directs vendors and internal business partners to facilitate timely claims resolution. Serves as a resource for team members on complex claims. Delivers a best-in-class member service experience by setting appropriate expectations and providing proactive communication. Supports workload surges and catastrophe (CAT) response operations as needed, including mandatory on-call dates and potential evening, weekend, and/or holiday work outside normal work hours. May be assigned CAT deployment travel with minimal notice during designated CATs. Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed. Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.