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Complex Claims Examiner Jobs (NOW HIRING)

TransRe

Complex Claims Examiner

New York, NY · Hybrid

$140K - $180K/yr

As a member of FAIRCO, the Complex Claims Examiner will be responsible for adjusting Professional & Management Liability claims, with opportunities for experiences with other FAIRCO programs.

TransRe

Complex Claims Examiner

New York, NY · On-site

$140K - $180K/yr

As a member of FAIRCO, the Complex Claims Examiner will be responsible for adjusting Professional & Management Liability claims, with opportunities for experiences with other FAIRCO programs.

TransRe

Casualty Complex Claims Examiner

New York, NY · On-site

$120K - $200K/yr

... claims examiner to assume responsibility for a growing book of business. Responsibilities will include, but not be limited to: * Evaluating and making independent coverage determinations on complex ...

Americo

Complex Claims Examiner I

Kansas City, MO · On-site

Overview We are currently looking for an experienced Complex Claims Examiner I to join our growing Claims team! Key Responsibilities * Reviewing and investigating the company's contractual liability ...

TransRe

Casualty Complex Claims Examiner

New York, NY · Hybrid

$120K - $200K/yr

... claims examiner to assume responsibility for a growing book of business. Responsibilities will include, but not be limited to: * Evaluating and making independent coverage determinations on complex ...

Tristar Insurance

Claims Examiner III (Hybrid)

Fresno, CA · On-site

$35 - $43/hr

... Examiners, and other TRISTAR staff in the office; therefore consistently being at work in the ... Effectively manages a caseload of 150 to 180 workers' compensation files, including complex claims.

Tristar Insurance

Claims Examiner III (Hybrid)

Fresno, CA · Hybrid

$35 - $43/hr

... Examiners, and other TRISTAR staff in the office; therefore consistently being at work in the ... Effectively manages a caseload of 150 to 180 workers' compensation files, including complex claims.

Richmond National

Sr. Claims Examiner

Glen Allen, VA · On-site

On-site in Glen Allen, VA We are seeking a highly skilled Senior Claims Examiner to independently manage a portfolio of complex, high-severity E&S commercial general liability (CGL) claims. This role ...

Venbrook

Senior Claims Examiner

Los Angeles, CA · On-site

Senior Claims Examiner, Public Entity DEPARTMENT: Claims Services LOCATION: Onsite - Downtown LA ... Demonstrates strong listening skills and the ability to convey complex claims information in a ...

Venbrook

Senior Claims Examiner

Los Angeles, CA

Senior Claims Examiner, Public Entity DEPARTMENT: Claims Services LOCATION: Onsite - Downtown LA ... Demonstrates strong listening skills and the ability to convey complex claims information in a ...

Next Step Systems

Claims Examiner

Tucson, AZ · On-site

Claims Examiner, Tucson, AZ Under general supervision from the Director of Operations, the ... learn complex business processes and understand the underlying transactional systems. - Strong ...

Next Step Systems

Claims Examiner

Tucson, AZ · On-site

Claims Examiner, Tucson, AZ The Claims Examiner needs experience with ICD-10, Current Procedural ... learn complex business processes and understand the underlying transactional systems. - Strong ...

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How much do complex claims examiner jobs pay per hour?

As of May 29, 2026, the average hourly pay for complex claims examiner in the United States is $29.40, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $35.10 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Complex Claims Examiner, and why are they important?

To thrive as a Complex Claims Examiner, you need advanced knowledge of insurance policies, legal regulations, and claims investigation, typically supported by a bachelor's degree and relevant industry experience. Familiarity with claims management software, data analysis tools, and sometimes certifications like AIC (Associate in Claims) are often required. Strong analytical thinking, attention to detail, and effective communication are standout soft skills in this role. These skills ensure accurate claim assessments, mitigate risk for the organization, and foster trust with clients and stakeholders.

What are some typical challenges a Complex Claims Examiner faces when handling intricate cases?

Complex Claims Examiners often deal with multifaceted cases that require in-depth analysis, thorough documentation review, and coordination with multiple stakeholders such as legal teams, medical professionals, and policyholders. One common challenge is interpreting ambiguous policy language and making fair determinations while remaining compliant with regulations. Additionally, managing high caseloads and tight deadlines can be demanding, so strong organizational and communication skills are essential. Successfully navigating these challenges helps build expertise and prepares examiners for future advancement within claims management.

What are Complex Claims Examiners?

Complex Claims Examiners are professionals who review, analyze, and process insurance claims that involve complicated circumstances, high-value losses, or ambiguous policy interpretations. They investigate claims by gathering evidence, interviewing involved parties, and consulting policy documents to determine the validity and extent of the insurer’s liability. These examiners work closely with legal teams, medical experts, or other specialists as needed to resolve claims efficiently and fairly. Their role is crucial in ensuring that claims are handled accurately while minimizing fraud and ensuring compliance with regulations.

What is the difference between Complex Claims Examiner vs Claims Adjuster?

AspectComplex Claims ExaminerClaims Adjuster
Required CredentialsInsurance license, sometimes certifications like CPCU or AICInsurance license, often similar certifications
Work EnvironmentInsurance companies, claims departmentsInsurance companies, independent agencies, or third-party administrators
Job FocusEvaluating complex or high-value claims, detailed analysisInvestigating, negotiating, and settling claims

The Complex Claims Examiner specializes in reviewing and analyzing complex or high-value insurance claims, often requiring detailed assessments and specialized knowledge. Claims Adjusters handle a broader range of claims, including simpler cases, focusing on investigation and settlement. While both roles require insurance licensing and similar certifications, the Complex Claims Examiner typically deals with more intricate cases within insurance companies' claims departments.

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What job categories do people searching Complex Claims Examiner jobs look for? The top searched job categories for Complex Claims Examiner jobs are:
Complex Claims Examiner jobs near you
Complex Claims Examiner

Complex Claims Examiner

TransRe

New York, NY • Hybrid

$140K - $180K/yr

Full-time

PTO

Posted 3 hours ago

Job description

About Us

Since 1977 we have delivered first class solutions to insurers worldwide, by combining global reach with local decision making. We have built customer & broker relationships on years of trust, experience and execution. Through our people, our products and our partnerships, we deliver the capacity and expertise necessary to contribute to the sustainable growth of prosperous communities worldwide. To do so, our colleagues work with:

IntegrityWork honestly, to enhance TransRe's reputation

RespectValue all colleagues. Collaborate actively.

PerformanceWe reward excellence. Be accountable, manage risk and deliver TransRe's strengths

EntrepreneurshipSeize opportunities. Innovate for and with customers.

Customer FocusAnticipate their priorities. Exceed their expectations.

We have the following job opportunity in our New York City office:

Description

We seek an experienced claims professional to join our growing FAIRCO team in our New York City office. FAIRCO is a subsidiary of TransRe Holdings, a Berkshire Hathaway company. As a member of FAIRCO, the Complex Claims Examiner will be responsible for adjusting Professional & Management Liability claims, with opportunities for experiences with other FAIRCO programs. Responsibilities will include but not be limited to:

  • Managing and adjusting primary and excess Professional & Management Liability claims, including private and public company, Directors and Officers, lawyers liability, accountants liability, financial institutions, cyber, employment practices and miscellaneous professional liability.
  • Proactively handling claims throughout the entire claim lifecycle from inception to resolution.
  • Analyzing policy coverage and drafting coverage analyses based on contract terms and claim details.
  • Evaluating liability and damages to determine the level of exposure to the insured and the policy.
  • Directing and closely monitoring assignments to defense counsel and experts in accordance with relevant guidelines.
  • Collaborating with underwriters, brokers, program partners, and insureds to ensure seamless claims resolution.
  • Traveling to and attending claims mediations, as required.
  • Developing and implementing claims handling strategies to mitigate risk and reduce claim expenses.

Requirements

The ideal candidate will possess the following knowledge, skills and abilities:

  • Extensive experience litigating or handling issues pertaining to complex Professional & Management Liability issues, with a focus on Directors and Officers coverage.
  • Experience leading mediations for Professional & Management Liability claims.
  • Experience evaluating coverage under various types of policies, drafting coverage correspondence, and participating in claims investigations.
  • Track record of effectively managing defense counsel and legal spend, assessing liability and financial exposure, and effectively negotiating cost effective, good faith claims resolutions.
  • Juris Doctorate preferred.
  • Willingness to travel up to 25% of the time for mediations, industry conferences, and client meetings.
  • Possession of, or willingness to obtain, a New York and other state adjuster's licenses.

Work Schedule

TransRe is supportive of an agile work schedule, which may differ based on individual roles, your local office's practices and preferences, marketplace trends, and TransRe's business objectives. This position is eligible for a hybrid work schedule with 3 days in the office per week, and 2 days remote.

Compensation

In addition to base salary, for this position, TransRe offers a comprehensive benefits package, paid time off, and incentive pay opportunity. The anticipated annual base salary range in New York for this position, exclusive of benefits, paid time off, and incentive pay opportunity is $140,000 - $180,000. This range is an estimate, and the actual base salary offered for this position will be determined based on certain factors, including the applicant's specific skill set and level of experience.

We are an Equal Opportunity Employer (EOE) and we support diversity in the workforce.

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