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Sr. Complex Claims Examiner, Major Case Unit
Sr. Complex Claims Examiner, Major Case UnitArch Capital Group • Jersey City, NJ, US
Sr. Complex Claims Examiner, Major Case Unit

Sr. Complex Claims Examiner, Major Case Unit

Arch Capital Group • Jersey City, NJ, US
30+ days ago
Job type
  • Full-time
Job description

Claims Manager

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, we enable possibility.

$10k Sign-on Eligible

Position Summary

Responsibilities include actively managing and effectively overseeing large exposure and complex general / auto liability and trucking claims (primary, umbrella and excess) direct handled by Third-party Administrators ("TPA's") and supporting Arch business stakeholders. This role does require managing any direct reports but is responsible for managing the claims and TPA process.

Responsibilities

  • Deliver industry leading technical claim handling / oversight, claim outcomes, business support and customer service.
  • Collaborate with TPA team members, Arch Claim Account Managers ("CAM's") and other claim professionals to proactively develop and effectively execute on appropriate claim resolution strategies.
  • Work closely with underwriters, Legal, Operations, claim professionals, and other Arch functions, to ensure timely and effective communication consistent with Arch Claims' Procedures, striving to achieve optimum claim outcomes.
  • Effective and timely communication with insureds and brokers; making exceptional customer service a top priority.
  • Coverage analysis, investigation, liability and damage evaluation, timely and accurate indemnity and expense reserving (within specific granted authority), litigation management, vendor management, settlement negotiations, including use of structure settlements where appropriate, and claim resolution.
  • Effective claim file documentation, claim coding and diary management.
  • Retain and work closely with defense and coverage counsel to create and execute on litigation / coverage strategies and budgets. Analyze and pay legal bills, consistent with claims specific strategy / budget and Arch Claims Litigation Management Guidelines.
  • Effective and timely claim reporting (verbal and written) to other claim professionals / management and business stakeholders, per Arch Claims Procedures.
  • Attend mediations, trials, other proceedings and meetings.
  • Maintains all required state adjustor licenses.
  • Assist CAM's and others with TPA management and oversight to include : TPA claim staff training relating to Arch processes, procedures, expectations, reporting, technical claim handling, litigation / vendor management, legal / regulatory developments, customer service and other topics that may arise; Sharing of claim handling / customer service best practices; Assistance with claim file reviews and claim audits; Regular meetings with TPA claims staff.

Experience & Required Skills

  • Trucking, construction, emergency service / medical professional liability claim handling experience is a plus.
  • TPA management / oversight experience is a plus.
  • Excellent customer service skills and service minded.
  • Strong analytical and problem-solving skills.
  • Strong negotiation skills.
  • Exceptional communication (written and verbal), collaboration, influencing, listening, and interpersonal skills to effectively develop productive working relationships both within and outside Arch.
  • Able to process large amounts of complex information, distill it down to key issues and decision points and concisely communicate the information verbally and in writing.
  • Able to effectively lead strategic discussions and leverage technical knowledge to make sound, cost-effective decisions and recommendations.
  • Able to work well independently and in a highly collaborative team environment.
  • Adaptable and able to succeed in a rapidly changing workplace.
  • Strong Microsoft Excel, PowerPoint and Word skills.
  • Willing and able to travel approximately up to 10% of time.
  • Education

  • Juris Doctorate required.
  • Minimum of 10 years commercial general / auto liability claim handling experience, including responsibility for complex and large exposure claims, or insurance defense / coverage practicing attorney with similar law firm experience.
  • The base salary range is $145,000 - $160,000 / year. The total individual compensation offered will take into account a number of factors including geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future.

    Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more.

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    Claim Examiner • Jersey City, NJ, US

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