Professional Liability Claims Examiner, III

TRISTAR Insurance Group

. Manage all aspects of Professional Liability claims from inception through resolution within established authority and company guidelines .

Posted 10/3/2026full-timeRemote • Texas • United StatesMid-LevelSenior💰 $80,000 - $95,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing Professional Liability claims, including coverage determination, loss exposure assessment, and settlement strategy communication. Proficient in analyzing complex claims and providing exceptional client service while adhering to statutory regulations and company guidelines.

Highest-signal resume keywords

Professional Liability Claims ManagementCoverage DeterminationAnalytical SkillsExcellent Written And Verbal CommunicationActive Independent Adjuster New York State License

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ExaminationLoss Report PreparationSubrogation InitiationPolicy InterpretationReserve Evaluation

Soft Skills

Client InteractionIndependent ManagementTeam Collaboration

Tools & Technologies

Microsoft WordMicrosoft Excel

Certifications & Qualifications

Independent Adjuster New York State License

Industry Keywords

Statutory RegulationsMedical TerminologyClaims ProcessingLoss ExposureRisk-Transfer Recovery

About the role

Key responsibilities & impact

Manage all aspects of Professional Liability claims from inception through resolution within established authority and company guidelines
Review policy information, endorsements, and vehicle schedules to determine coverage for loss, damage, or injury
Examine and investigate claims, including matters in litigation, through final resolution
Interact frequently with claimants and their legal representatives
Communicate recommendations regarding loss exposure, reserves, and settlement strategy to clients
Review, process, and conclude assigned professional liability claims
Interpret policies and make coverage determinations
Oversee and direct outside investigative service providers
Work with clients, client counsel, and investigative services to advance claims to conclusion
Maintain an ongoing claim diary
Assess exposure and evaluate reserves and settlement recommendations
Prepare detailed Loss Reports analyzing liability and damages
Determine and initiate subrogation or risk-transfer recovery efforts when applicable
Document correspondence, reports, discussions, and decisions in claim files
Provide outstanding client service
Assist supervisors and the Claim Department with requested tasks or special projects
Work remotely from home under the oversight of the Area Manager and reporting to the Claim Supervisor and/or Area Manager

Requirements

What you’ll need

Bachelor’s degree in related field preferred; five (5) or more years related experience; or equivalent combination of education and experience
Technical knowledge of coverage, statutory regulations, and medical terminology
Analytical skills
Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients, and staff
Ability to interact with people at all levels in the business environment
Ability to independently and effectively manage very complex claims
Proficient in Word and Excel preferred
Active Independent Adjuster New York State License
High School Diploma or GED listed as the education level