STD Claims Examiner II making accurate claim decisions for Short Term Disability claims. Collaborating with team members in a hybrid work environment from South Portland, ME.
About the role
- Claims Specialist managing a caseload of complex Personal and Advertising Injury Liability claims. Requires strong analytical skills and experience in litigation and high exposure claims.
Responsibilities
- Handling a caseload of complex, high exposure, Personal and Advertising Injury Liability claims throughout the claim’s life cycle
- Conducting investigations and analyzing and evaluating the information learned
- Making coverage determinations and communicating written position(s) to insureds and other required parties
- Within prescribed authority levels, setting appropriate expense and indemnity reserves and monitoring on a regular basis for any needed adjustment
- Presenting cases to management for expense or indemnity reserve authority above established authority levels
- Developing and implementing resolution strategies to achieve high quality outcomes
- Proactively managing litigation and counsel, inclusive of litigation planning and execution, budgeting and bill review
- Attending trials and mediations as necessary
- Contributing to broader claim and enterprise goals by participating in audits, projects and product development initiatives
- Preparing comprehensive reports and delivering presentations to senior claim leadership on case developments, policy issues, industry trends, etc.
- Providing support to field offices to assist field personnel with coverage and liability analysis, time limit demands, extra contractual exposure evaluations and other issues of complexity
- Work with business partners to evaluate and address claim trends and developments
- Address inquiries from agents and policyholders, providing superior customer service
Requirements
- Bachelor’s Degree is required, law degree a plus
- Minimum of 7 years’ experience handling complex claims, litigated coverage and liability matters required
- Candidate should be disciplined, results-oriented and able to focus on bottom line results
- Superior analytical ability and organizational skills
- Excellent oral and written communication skills
- Excellent strategic thinking ability and execution skills
- Excellent negotiation and advanced technical claim handling skills, including knowledge of coverage and tort laws
- An ability to communicate thoughts clearly and concisely and to influence and persuade others
- Superior interpersonal skills
- An ability to exceed expectations and influence others to do the same
Benefits
- Health insurance
- 401(k) matching
- Paid time off
- Flexible work arrangements
- Professional development opportunities
- Short-term or annual bonuses
- Long-term incentives
- On-the-spot recognition
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