Claims Specialist

This is a fully remote position, open to applicants in Arizona, +3 more states.

📋 Description

• Investigate and oversee intricate, multi-line, and multi-state claims, including general liability and workers’ compensation losses.

• Assess coverage, investigate the circumstances of loss, gather statements, evaluate medical and loss data, and formulate claim resolution strategies.

• Set reserves and ensure precise, timely documentation of claims.

• Analyze coverage, liability, compensability, damages, and settlement risks, and communicate claim decisions effectively.

• Identify and pursue subrogation possibilities and coordinate referrals to specialized resources.

• Negotiate and resolve complex claims within the designated authority.

• Prepare claim evaluations, settlement ranges, denial correspondence, and settlement documentation.

• Collaborate with defense counsel on litigated claims and advise clients on litigation and resolution strategies.

• Ensure compliance with state reporting, Medicare, excess carrier, and other claim-related regulations.

• Foster client relationships through communication, consultation, file assessments, claim summaries, and resource coordination.

• Analyze claim and settlement trends to pinpoint opportunities and support client needs.

• Act as a technical resource for Claims team members.

• Cover the states of Iowa, Arizona, Utah, and Texas.

⛳️ Requirements

• Bachelor’s degree or equivalent relevant experience.

• Seven years of experience in claims adjusting or related fields.

• Must possess adjusters' experience in Iowa, Arizona, and Utah.

• Experience as an adjuster in Texas is preferred.

• Previous experience with a third-party administrator (TPA) is preferred.

• INS, AIC, SCLA, WCLA, and CPCU designations are preferred.

• Advanced knowledge of best practices in claims for serious and complex injuries, workers’ compensation, general liability, property, and commercial auto claims.

• Exceptional understanding of the claims function.

• Strong analytical, investigative, and problem-solving skills related to liability and coverage.

• In-depth knowledge of insurance contracts, medical terminology, and the legal aspects of court procedures affecting legal liability.

• Proficient computer skills, including familiarity with claims systems.

• Outstanding organizational, written, and verbal communication skills, including documentation capabilities.

• Thorough investigative and problem-solving skills.

• Excellent ability to advise, collaborate, and consult with diverse internal and external stakeholders.

• Occasional travel may be required.

• Maintain necessary professional licenses and engage in continuing education.

🏝️ Benefits

• Comprehensive rewards package.

• Tobacco-free workplaces and company vehicles.