Claims Specialist II

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

📋 Description

• Investigate, assess, negotiate, and resolve claims of moderate to high complexity within CD and E&S.

• Conduct prompt and comprehensive investigations while confirming applicable coverages.

• Analyze liability and evaluate damages to determine reserves and settlement amounts.

• Decide on resolving lawsuits prior to appointing defense counsel.

• Vet and engage suitable defense counsel.

• Collaborate with defense counsel to strategize case management and action plans.

• Proactively manage claim files and defense counsel to facilitate claims resolution.

• Document file activities with detailed notes and prepare claim reports.

• Recommend reserves in accordance with timeliness and accuracy standards.

• Develop and implement negotiation strategies.

• Identify subrogation opportunities and prepare claims for recovery.

• Recognize risk transfer opportunities and exposures.

• Draft tender letters and notify potential parties.

• Vet, select, and engage experts as necessary.

• Implement expense management initiatives.

• Inform insureds of significant developments and demands; communicate major exposure changes to the agency and underwriting.

• Review fee statements and negotiate necessary adjustments.

• Investigate coverage and establish limits and attachment points on excess files.

• Draft letters regarding coverage positions.

• Apply priority of coverage rules.

• Escalate requests for monitoring or coverage counsel when required.

• Monitor underlying carriers and engage in defense strategy discussions.

• Notify underwriting of heightened hazards or unusual circumstances.

• Participate in educational programs and claims committees to enhance expertise and promote claims initiatives.

⛳️ Requirements

• High school diploma.

• Fulfill the relevant state licensing requirements for claims handling.

• Over 6 years of experience in Property/Casualty claims management.

• CPCU, AIC, SCLA or Legal Principles, CCLA, and PCLA from the AEI series is preferred or should be completed within 2 years of hiring.

• Ability to assess coverage, risk transfer, liability, and bodily injury evaluations for reserves and settlements.

• Moderate understanding of best practices in claims handling.

• Moderate knowledge of unfair claims practices and bad faith.

• Familiarity with various lines of policy coverages.

• Ongoing knowledge of relevant laws, regulations, and venue.

• Awareness of fraud indicators.

• Understanding of civil procedure.

• Excellent communication skills.

• Strong attention to detail and ability to manage multiple tasks effectively and efficiently.

• Occasional travel may be necessary.

🏝️ Benefits

• Annual incentive compensation.

• Medical, dental, vision, and life insurance.

• Accident, critical illness, and short-term disability insurance.

• Retirement plans with employer contributions.

• Generous time-off policy.

• Programs designed to enhance employee well-being and financial security.

• Company-sponsored educational programs and additional learning opportunities.