Senior Complex Claims Specialist

Job Title

Senior Complex Claim Professional

Responsibilities

Under limited supervision, the Senior Complex Claim Professional is an individual contributor who investigates, evaluates, negotiates, and resolves the highest complexity litigated and non-litigated claims across multiple lines of business, including General Liability, Products Liability, and Professional Liability. The ideal candidate possesses expert-level coverage knowledge and embraces and advances Best Practices claims handling to industry and company standards, procedures, and objectives.

• Welcome working in a team-oriented collaborative environment with other seasoned Claim Professionals
• Exhibit expert-level knowledge of the claims process, best practices, and litigation management
• Active and affable contributor to the claim process, roundtables, and pre-trial calls to share knowledge and advance skills of others
• Analyze and identify coverage issues, prepare coverage letters with expert level coverage knowledge, and collaborate with in-house coverage counsel
• Investigate, evaluate, document, and reserve, assessing liability and damages according to Best Practices
• Manage litigation by assigning counsel from the approved panel where applicable, establish litigation plan and budget, coordinate with defense counsel, and continuously review for potential resolution.
• Establish timely reserves and continuously re-evaluate their adequacy upon receipt of new information
• Maintain timely and appropriate file documentation and written file notes
• Maintain an active diary and productive file inventory
• Timely completion of all required large loss reporting
• Negotiate settlements within authority, and attend mediations, mandatory settlement conferences, and / or Alternative Dispute Resolutions
• Possess a proactive approach to claim resolution and cost controls
• Develop and maintain positive customer relationships and provide superior customer service
• Timely identify and pursue all potential opportunities for co-insurance, risk transfer and / or subrogation
• Recognize and investigate suspected fraudulent claims
• Comply with deductible / self-insured retention and recovery protocols
• Meet all State licensing requirements
• Adhere to all statutory regulations, Unfair Claims Practices acts, and corporate Best Practices
• Serve as mentor and contributor for claims associates; provide technical advice
• Assist management with project-oriented work, presentations, and administrative tasks as needed

Qualifications

Additional Company Details

We do not accept any unsolicited resumes from external recruiting firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees including : Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. This role is eligible to participate in the annual discretionary bonus program.

Sponsorship Details

Sponsorship not Offered for this Role