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            Claims Representative III

            Capital Insurance Group
            Monterey, CA 93940
            Full-time, Part-time
            Refer friends, get paid!

            Job Description

            Job Description

            Analyzes, investigates, and evaluates the loss to determine coverage and claim disposition. Utilizes CMS to document claims and to diary future events or follow-up. Within prescribed settlement authority, establishes appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Makes recommendations to set reserves at appropriate level for claims outside of authority level.

            The ideal candidate will work out of our office in Westlake Village, CA. We are also open to a remote candidate in the Greater Los Angeles area.



            • Prepares comprehensive reports as required.
            • Primarily Commercial/GL claims, with a strong focus on habitability claims. May also be responsible for some claims in personal lines.
            • Identifies and communicates specific claim trends and account and/or policy issues to management and underwriting.
            • Manages the litigation process through the retention of counsel.
            • Adheres to the line of business litigation guidelines to include budget, bill review and payment.
            • Heavy litigation responsibility from beginning to end, pro-actively manages the case resolution process.
            • Pro-actively manages the case resolution process.
            • Actively participates in mediations and arbitrations, as well as negotiation discussions within limit of settlement authority.
            • Participates in the claims audit process.
            • As required, maintains insurance adjuster licenses.



            • Bachelors' and/or advanced degree.
            • 7 + years claims experience, with at least 2 years within the technical specialty.
            • Advanced knowledge of claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge.
            • Functional knowledge of law and insurance regulations in various jurisdictions.
            • Demonstrated superior verbal and written communications skills.
            • Advanced analytical, decision making and negotiation skills
            • Associate in Claims (AIC) certification required
            Posting ID: 595656176Posted: 2021-01-20