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Complex Claims Specialist (Remote)
Complex Claims Specialist (Remote)Selective Insurance • Branchville, New Jersey, United States
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Complex Claims Specialist (Remote)

Complex Claims Specialist (Remote)

Selective Insurance • Branchville, New Jersey, United States
30+ days ago
Job type
  • Full-time
  • Remote
Job description

About Us

At Selective, we don't just insure uniquely, we employ uniqueness.

Selective is a midsized U.S. domestic property and casualty insurance company with a history of strong, consistent financial performance for nearly 100 years. Selective's unique position as both a leading insurance group and an employer of choice is recognized in a wide variety of awards and honors, including listing in Forbes Best Midsize Employers in 2024 and certification as a Great Place to Work in 2024 for the fifth consecutive year.

Employees are empowered and encouraged to Be Uniquely You by being their true, unique selves and contributing their diverse talents, experiences, and perspectives to our shared success. Together, we are a high-performing team working to serve our customers responsibly by helping to mitigate loss, keep them safe, and restore their lives and businesses after an insured loss occurs.

Overview

Selective Insurance is seeking a Complex Claims Specialist for this remote position. The purpose of this position is to provide direct handling of the company's Specialty Claims - Management Liability (D&O, EPL, and Fiduciary).

Responsibilities of this position include coverage analysis, investigation, evaluation, negotiation and disposition of assigned claims. Candidate must possess strong communication and litigation management skills to collaborate with insureds and defense counsel to direct litigation activities, budgets and claim outcomes while considering the overall impact to the customer and company. The individual in this position will also ensure claims are processed within company policies, procedures, and within individual's prescribed authority with exceptional standards of performance. This individual should possess strategic thought process skills to effectively and efficiently manage loss exposures. Job duties will include communication and collaboration with key stakeholders, training, development and providing thought leadership where requested. The position may require travel to mediations, arbitrations, settlement conferences, trials, training or other proceedings which may account for up to 10% of the specialist time. All job duties and responsibilities must be carried out in compliance with applicable legal and regulatory requirements.

Responsibilities

  • Effectively evaluate and resolve coverage issues for Directors & Officers, Employment Practices, and Fiduciary claims.
  • Investigate the claims through telephone, written correspondence, and / or personal contact with claimants, attorneys, insureds, witnesses and others having pertinent information.
  • Effectively and efficiently present claims and claim trends to Claim and Underwriting Leadership to include discussion of coverage, liability assessment and ultimate exposure to the insured and company.
  • Timely analyze information in order to evaluate assigned claims to determine ultimate exposure to the insured and company.
  • Effectively evaluate, negotiate and resolve claims within delegated authority utilizing the appropriate denials or releases.
  • Provide required reports to claims, underwriting, reinsurance and actuarial on significant exposure cases.
  • Report on all cases going to trial on a timely basis and attend portions of trials when warranted or requested by management.
  • Ensure proper referrals and timely updates to appropriate Reinsurer(s).

Qualifications

Knowledge and Requirements

  • Experience in complex coverage analysis and significant large loss evaluations. Superior communication and strategic negotiation and claim disposition skills along with proven problem-solving skills. Excellent presentation skills and moderate proficiency with standard business-related software (including Microsoft Outlook, Work Excel, and PowerPoint). Sufficient keyboarding proficiency to enter data accurately and efficiently. Multi-State licensing with strong understanding of Medicare reporting & compliance preferred. Must have valid state-issued driver's license in good standing and be able to drive an automobile.
  • Education and Experience

  • College degree required.
  • JD (law degree) or MBA (Masters in Business Administration) preferred.
  • 8+ years claims handling experience involving primary / duty to defend policies, with significant experience handling Directors & Officers, Employment Practices, and Fiduciary claims with a primary P&C carrier.
  • Experience in coverage analysis and claim evaluations.
  • Superior communication skills and strategic negotiation and claim disposition skills along with proven problem-solving skills.
  • Excellent presentation skills.
  • Moderate proficiency with standard business-related software (including Microsoft Outlook, Work Excel, and PowerPoint).
  • Sufficient keyboarding proficiency to enter data accurately and efficiently.
  • Must have valid state-issued driver's license in good standing and be able to drive an automobile.
  • Total Rewards

    Selective Insurance offers a total rewards package that includes a competitive base salary, incentive plan eligibility at all levels, and a wide array of benefits designed to help you and your family stay healthy, achieve your financial goals, and balance the demands of your work and personal life. These benefits include comprehensive health care plans, retirement savings plan with company match, discounted Employee Stock Purchase Program, tuition assistance and reimbursement programs, and paid time off plans. Additional details about our total rewards package will be provided during the recruiting process.

    The actual base salary is based on geographic location, and the range is representative of salaries for this role throughout Selective's footprint. Additional considerations include relevant education, qualifications, experience, skills, performance, and business needs.

    Pay Range

    USD $108,000.00 - USD $163,000.00 / Yr.

    Additional Information

    Selective is an Equal Employment Opportunity employer. That means we respect and value every individual's unique opinions, beliefs, abilities, and perspectives. We are committed to promoting a welcoming culture that celebrates diverse talent, individual identity, different points of view and experiences - and empowers employees to contribute new ideas that support our continued and growing success. Building a highly engaged team is one of our core strategic imperatives, which we believe is enhanced by diversity, equity, and inclusion. We expect and encourage all employees and all of our business partners to embrace, practice, and monitor the attitudes, values, and goals of acceptance; address biases; and foster diversity of viewpoints and opinions.

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    Claim Specialist • Branchville, New Jersey, United States

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