Complex Claims Specialist handling mid to high-severity Professional Liability claims. Adjusting and resolving claims while mentoring team members and driving defense strategy with external partners.
Responsibilities
Adjusts and resolves complex mid to severity claims that include all phases of litigation.
With minimal supervision, drafts complex coverage letters, including reservation of rights and denial letters.
Reviews and provides analysis of claim documentation and legal filings.
Drives litigation best practices to lead defense strategy on litigated files.
Mentors team members.
Uses superior knowledge and experience to affect positive claim outcome via investigation, negotiation and utilization of alternative dispute resolutions.
Identifies emerging exposures and claims trends.
Identifies suspected fraudulent claims and tracks with special investigations unit.
Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities.
Requirements
6+ years of Professional Liability and/ or Specialty/Financial lines claims handling experience.
A JD from an ABA accredited law school may be considered as a supplement to claims handling experience.
Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation.
Ability to work in a fast-paced and changing environment.
Advanced knowledge of coverage within the team’s specialty or focus.
Advanced knowledge of litigation process and negotiation skills.
Experience in mentoring and training other claims examiners.
Excellent verbal and written communication skills.
Advanced analytical skills.
B.A./B.S Degree required, JD optimal.
Adjuster licensing is required within 90 days of employment.
Benefits
Competitive salary and bonus (based on personal & company performance)
401(k) with competitive company matching
Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care)
Company paid group term life, short- term disability and long-term disability coverage
24 Paid time off days, 2 Hiscox Days, 10 paid holidays, and ability to purchase 5 PTO days
Paid parental leave
4 week paid sabbatical after every 5 years of service
Financial Adoption Assistance and Medical Travel Reimbursement Programs
Annual reimbursement up to $600 for health club membership or fees associated with any fitness program
Company paid subscription to Headspace to support employees’ mental health and wellbeing
Dynamic, creative and values-driven culture
Modern and open office spaces, complimentary drinks
Claims Representative managing insurance claims for Great American Insurance Group. Evaluating liability and negotiating settlements while working in a hybrid model from Cincinnati, OH.
Claims Representative handling entry - level insurance claims at Auto - Owners Insurance. Investigating, evaluating, and settling claims under close supervision in a merit - based work - from - home program.
Claims Processor at Highmark overseeing claims adjustments and inquiries. Responsible for processing complex claims and ensuring timely resolution of payment determinations.
Claims Adjuster managing complex indemnity claims at AvonRisk. Collaborating with teams to ensure accurate claim management and compliance with legal requirements.
Workers Compensation Claims Adjuster III managing complex claims at AvonRisk. Reports to Claims Supervisor and oversees assigned inventory with a focus on professional growth and support.
Claims Adjuster managing complex workers' compensation claims for AvonRisk. Ensuring timely and effective case management with a focus on solutions and collaboration.
Disability Claims Analyst at RBC Insurance evaluating disability claims and communicating with clients. Collaborating with cross - functional teams and managing high - volume cases.
Disability Claims Specialist evaluating disability claims at RBC Insurance. Collaborating across teams to ensure excellent client service and effective claims management.
Multi - Line Claims Adjuster handling high - value liability, property, and automobile claims for municipal clients. Engaging with attorneys and managing litigation from start to finish.
Lead role investigating and maintaining complex property claims in East/Central Missouri. Field - based position requiring customer interaction and extensive claims expertise.