Senior Commercial Claims Examiner

Frontline Insurance

Senior Commercial Claims Examiner managing complex commercial claims at Frontline Insurance. Ensuring high-quality service and adherence to best practices and regulations in the claims process.

Posted 5/12/2026full-timeRemote • 🇺🇸 United StatesSeniorWebsite

About the role

Key responsibilities & impact

Verify facts of loss and pertinent information to analyze and confirm coverage.
Establish ultimate reserves (anticipated cost to bring file to closure based on known facts) as soon as practical and monitor to adjust at the time of any exposure changing event.
Explain and appropriately respond to insured’s, public adjusters, attorney’s and contractors during telephone contacts; as well as, contact the appropriate parties to obtain any needed information, provide timely investigation status updates, explain settlements and/or ultimate claim disposition.
Timely submit reserve and payment approval requests, as appropriate.
Identify claims requiring a Reservation of Rights and refer for management approval.
Formulate and execute appropriate ADR strategy in compliance with statutory guidelines.
Check e-mails and messages daily.
Respond to all calls, emails, and questions daily.
Apply advanced negotiation skills to effectuate resolution of disputed claims with insureds or their legal representative.
Coordinate appraisal process , maintain communication necessary to ensure appraisal process is moving forward in timely fashion.
Draft denial letters for management approval.
Identify and refer claims with subrogation potential to the subrogation department.
Identify and refer cases with potential NICB fraud indicators.
Virtually investigate and resolve claims, as appropriate, with the use of video technology.
Close all files as appropriate in a timely and complete manner.
Serve as mentor and/or trainer, as needed, to junior adjusters.
Strictly adhere to Best Practices and operational guidelines, as well as all statutory requirements.
Interfaces with company clients, carrier , adjusters, or covered parties.
Communicates with agents regarding status of claim.
Completes and/or reviews, approves, or elevates reservation of rights letters, payment explanation correspondence, denial letters, or partial denial letters, as applicable.
Resolves disputes regarding claims resolution.
Responsible for reopening and re-evaluating claim, as necessary.
Participates in litigation when applicable.

Requirements

What you’ll need

Bachelor's degree
A minimum of 10 years of Commercial claims experience preferred.
In-depth professional knowledge of all aspects of claims operations.
Florida 520/620 license is required.
Ability to obtain AL, GA, NC and SC adjusters licenses.
Strong commercial coverage interpretation and claims handling background is required.
Must have commercial construction knowledge and be proficient in Xactimate.

Benefits

Comp & perks

Remote work schedule!
Health & Wellness: Company-sponsored Medical, Dental, Vision, Life, and Disability Insurance (Short-Term and Long-Term).
Financial Security: 401k Retirement Plan with a generous 9% match
Work-Life Balance: Four weeks of PTO and Pet Insurance for your furry family members.

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

claims analysisnegotiation skillscommercial coverage interpretationclaims handlingXactimateADR strategy formulationfact verificationreserve establishmentsubrogation identificationfraud indicators identification

Soft Skills

communicationmentoringtrainingorganizational skillsinterpersonal skillsproblem-solvingtimelinessattention to detailadaptabilityconflict resolution

Certifications

Bachelor's degreeFlorida 520/620 licenseAL adjusters licenseGA adjusters licenseNC adjusters licenseSC adjusters license