Claims Litigation Specialist

This is a fully remote position, open to applicants in Texas.

📋 Description

• Interpret policy documents and legal contracts.

• Analyze and identify coverage and related coverage issues.

• Utilize knowledge of insurance contracts, Unfair Claims Settlement Practices, insurance codes, civil codes, vehicle codes, arbitration rules and regulations, tort law, and claims best practices.

• Manage, investigate, and resolve claims within established authority levels.

• Recommend ultimate resolutions on cases that exceed authority to claims management.

• Handle General Liability and Casualty litigation files.

• Proactively drive litigation and attend mediations, trials, and alternative dispute resolution proceedings.

• Communicate with policyholders, witnesses, and claimants to collect claim information and provide guidance on appropriate actions.

• Respond to written and telephone inquiries, including status updates.

• Present file materials for authority reviews and roundtable discussions.

• Collaborate with nurses, doctors, attorneys, internal teams, leadership, and independent field adjusters.

• Ensure compliance with statutory and regulatory requirements.

• Meet quality assurance standards and performance objectives.

• Set and adjust case reserves in accordance with reserving policy.

• Identify suspicious claims and escalate them to SIU; recognize third-party subrogation opportunities.

• Maintain the security of claims financial processing and claims-file information.

• Provide claim-specific guidance to independent field adjusters.

• Advise leadership on key claim activities and potential exposures.

⛳️ Requirements

• BS/BA degree is required.

• Advanced studies or insurance designation is preferred.

• A minimum of 10+ years of directly related experience in Commercial General Liability and Litigation.

• Strong written and verbal communication, interpersonal, analytical, investigative, and negotiation skills.

• Extensive knowledge of multi-jurisdictional claims handling issues.

• Willingness to utilize and adapt to evolving claims-operation technologies.

• Ability to work independently as a self-starter.

• Must possess or promptly obtain a Texas Independent Adjuster License.

• Ability to collaborate effectively with cross-functional teams.

• Proven track record of delivering strong results in a dynamic claims environment.

• Commitment to excellence, adherence to company policies, and regulatory compliance.

• Team-oriented mindset with the ability to cultivate strong working relationships.

• Comfort in navigating ambiguous environments and assisting colleagues or organizational projects.

• Open to feedback and willing to learn new proprietary and off-the-shelf software systems.

• Willingness to travel, likely up to 10%.

🏝️ Benefits

• Eligibility for an annual performance-based incentive program.

• Partially subsidized medical plan.

• Fully subsidized vision and dental options.

• Life insurance coverage.

• Disability insurance.

• 401(k) retirement plan.

• Flexible paid time off.

• Parental leave.

• Equal employment opportunities in a diverse and inclusive workplace.