Claims Examiner II

The Baldwin Group

. Analyze insurance policies and documents to determine coverage .

Posted 9/17/2026full-timeRemote • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in analyzing insurance policies and handling complex 1st Party Property Claims while providing Best-In-Class customer service. Proficient in evaluating claims, negotiating settlements, and ensuring compliance with industry standards and regulations.

Highest-signal resume keywords

Property & Casualty Insurance LicenseClaims Handling ExpertiseNegotiation SkillsCustomer Service ExcellenceStrategic Vision

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AnalysisLiability InvestigationSettlement EvaluationClaims Inventory ManagementFraud Detection

Soft Skills

Effective CommunicationRelationship DevelopmentTactical Execution

Tools & Technologies

Claims Management Software

Certifications & Qualifications

State Adjuster’s License

Industry Keywords

Insurance Policies1st Party Property ClaimsBest PracticesSubrogationSIU

About the role

Key responsibilities & impact

Analyze insurance policies and documents to determine coverage
Investigate and analyze claim information to determine liability
Handle complex 1st Party Property Claims
Assist with suits, mediations, and arbitrations
Work with Counsel in the defense of litigation
Set timely, adequate reserves in compliance with company reserving philosophy
Engage experts to evaluate claims
Monitor vendor performance and control expenses
Evaluate, negotiate, and determine settlement values
Communicate with interested parties throughout the claim lifecycle
Discuss coverage decisions, additional information needs, and settlement amounts
Handle claims according to Best Practices
Monitor and complete assigned claims inventory
Provide Best-In-Class customer service to insureds and agents
Update and maintain claim files
Identify subrogation opportunities and protect recovery interests
Identify fraud indicators and refer files to SIU
Participate in internal and external claims audits
Provide oversight of TPAs

Requirements

What you’ll need

High School/GED
5–9 years of experience in claims
Must have Property & Casualty Insurance License
Acquire and maintain a state adjuster’s license
Meet state continuing education requirements
Technical knowledge in insurance claims handling
Ability to develop relationships and communicate effectively with diverse clients, carriers, and colleagues
Strategic vision and tactical execution to achieve goals and objectives

Benefits

Comp & perks

Best-In-Class customer service focus
Remote work arrangement