Claims Examiner Trainee

Posted 2025-03-14
Remote, USA Full-time Immediate Start

Looking for a new career? Interested in changing industries? Searching for opportunities to grow? Are you ambitious and eager to learn? Then, this might be the job for you! We are currently seeking a class of potential Claims Examiners to be trained to become our next generation leaders at TWIA/TFPA.

This is a remote work opportunity after completing the mandatory four weeks of training onsite in Austin, TX.

We value smart, energetic, and flexible people who want to make a daily contribution toward helping serve our policyholders and employees. If that?s you, we may have just the right opportunity for you. This role would be to learn the departments operations and processes in a fast-paced catastrophe environment while training to become a successful Claims Examiner and providing essential property insurance products and services for eligible Texas policyholders when no one else will.

The Claims Examiner Trainee is responsible for learning and demonstrating a basic understanding of insurance principles, claims investigation, damage evaluation, and resolution of property claims, creating a positive customer experience. A Claims Examiner Trainee provides prompt, cost effective and efficient examination, investigation, evaluation, and payment of insurance claims by exercising independent decision-making skills and judgment within designated authority.

SKILL-BASED CAREER PATH:
? Starting salary for a Claims Examiner Trainee is commensurate with the range minimum for the Pay Grade assigned to the position.
? Upon successful completion of the TWIA training requirements, including Texas Adjuster Licensing requirements, Bisys Property and Casualty Principles Course, and providing the claims examiner trainee employee is in good standing and meeting expectations with their development and work, the salary will be adjusted upward by 7%.
? Claims Examiner Trainees who continue to meet performance expectations are eligible for reassignment to Claims Examiner I the first review period following completion of the above training requirements, but no earlier than 6 months after completion of the training requirements or date of hire where starting salary already at 7% above minimum (whichever occurs later). The salary for Claims Examiner I is commensurate with the 1st Quartile of the pay grade for the position.

ESSENTIAL FUNCTIONS: The following are the usual, BASIC, and essential functions of the Claims Examiner Trainee position. However, this job description does not preclude the performance of other duties by the incumbent. These functions are not to be construed as an exhaustive list of all responsibilities, duties, and skills required:
? Demonstrates a customer centric attitude
? In coordination with an Adjuster, analyzes and manages claims by verifying coverage and investigating and gathering pertinent information to determine the exposure on the claim
? Maintains well-developed action plans for an appropriate and timely resolution in accordance with established policies and procedures
? Recognizes and properly addresses coverage issues, potential fraud, and subrogation potential
? Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout the life of the claim
? Conducts detailed damage and bill reviews and controls claim expenses
? Pays and processes claims within designated authority level or denies payments where no coverage, liability, or compensability exists
? Enters claim payments and reserves on claims on computer system, inputting concise and accurate file documentation
? Communicates decisions in a clear and professional manner

REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES:

REQUIRED EDUCATION AND EXPERIENCE:
? Associate degree (or equivalent experience in lieu of a degree)
? 1+ years of work experience

PREFERRED EDUCATION AND EXPERIENCE:
? Bachelor?s degree, 3.0 cumulative GPA or higher

ADDITIONAL TRAINEE REQUIREMENTS: ? Obtain an adjuster?s license required by the state of Texas within 90 ? 120 days of employment ? Successfully complete a Bisys Property and Casualty Principles course within 90 -120 days of employment ? Participate in training sessions consisting of self-study, classroom, and field-based activities ? Demonstrate basic proficiency in general insurance principles, basic investigation, policy interpretation, basic residential construction techniques, and verbal and written communication skills ? Develop and demonstrate effective organization and time management skills

PREFERRED KNOWLEDGE, SKILLS, AND ABILITIES:
? Bilingual; English and preferably Spanish and/or Asian Languages (such as Mandarin, Vietnamese, etc.)

PHYSICAL REQUIREMENTS: ? This position requires the ability to sit, hear, converse over the telephone, and key frequently on a computer for long periods of time. ? This position may require some limited overnight travel to complete training programs, activities, and meetings. ? This position may require overnight travel and remote work outside the office as part of our Organization-wide efforts to respond to high claim volume caused by catastrophic storm events.

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