Job Description

TPA Claims Examiner

Leap Recruitment Partners is proud to represent a distinguished global leader in the independent claims management and loss adjusting sector as they seek a dedicated TPA Claims Examiner to join their growing team.

The Role

In this pivotal position, you will take full ownership of a diverse claims portfolio, managing files from the initial report through to final resolution. You will serve as a key point of contact for a sophisticated client base, including London Market participants and domestic Canadian entities, ensuring high-quality outcomes across various lines of business such as Commercial General Liability (CGL), Medical Malpractice, Errors & Omissions (E&O), and Property.

Key Responsibilities

• Comprehensive File Management: Oversee the end-to-end lifecycle of property and liability claims, ensuring every file is handled with precision and expertise.

• Strategic Analysis: Critically evaluate reports from independent adjusters and experts, alongside legal documentation, to determine coverage, assess liability, and project quantum.

• Financial Stewardship: Establish and maintain accurate claim reserves in accordance with industry best practices and specific client mandates.

• Litigation Oversight: Orchestrate the management of litigated files by collaborating with external legal counsel, refining defense strategies, and maintaining strict control over legal expenditures.

• Professional Communication: Act as a primary liaison between insurers, brokers, and adjusters, providing clear, concise summaries and insightful client reporting.

• Recovery Identification: Proactively identify and pursue opportunities for subrogation, contribution, and other recovery avenues.

• Operational Excellence: Maintain meticulous documentation within claim files to meet internal protocols, regulatory standards, and bordereaux reporting requirements.

• Performance Standards: Ensure all work consistently aligns with established Service Level Agreements (SLAs) and rigorous reporting timelines.

What You Bring

• Professional Expertise: Proven experience operating as a desk examiner within a Third-Party Administration (TPA) environment.

• Market Knowledge: A strong background in handling London Market claims is highly preferred.

• Credentials: You hold a valid Provincial adjuster license and have completed a Post-Secondary degree (College or University).

• Industry Insight: Familiarity with the independent claims adjusting landscape, including a solid grasp of local jurisdictional mandates and regional claim practices.

• Soft Skills: Exceptional negotiation tactics paired with professional verbal and written communication abilities.

• Organization: The ability to effectively prioritize a high-volume workload while maintaining a keen analytical eye.

At Leap we are an Equal Opportunity and Affirmative Action Employer. That means all applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status. Leap will not tolerate any discrimination or harassment based on any of these characteristics. Leap encourages applicants of all ages.