Injury Resolution Specialist

This is a fully remote position, open to applicants in Connecticut, +21 more states.

📋 Description

• Investigate, assess, negotiate, and resolve bodily injury claims and associated coverages.

• Manage personal and commercial auto claims, uninsured and underinsured motorist claims, homeowners’ liability, commercial liability, and limited litigation claims.

• Review and analyze coverage details, policy conditions, provisions, exclusions, endorsements, limits, deductibles, and co-insurance factors.

• Gather and investigate information, including taking statements, to ascertain loss facts, liability, and potential for subrogation.

• Oversee and continually assess claims, focusing on injury severity, causality, and the relevance of medical treatment.

• Conduct necessary medical history investigations as part of the claims process.

• Determine and consistently evaluate appropriate reserve levels.

• Develop action plans and utilize relevant resources to progress files towards resolution.

• Investigate, evaluate, negotiate, and resolve an average of at least 20 losses monthly.

• Adhere to claims policies, best practices, and applicable jurisdictional guidelines.

• Prepare detailed reports and authorization requests.

• Utilize various claims systems and implement effective follow-up practices.

• Participate as a member of assigned claims teams.

• Stay informed about claims processes, procedures, systems, fair claims practices laws, compliance issues, and industry developments.

• Communicate effectively with stakeholders, including resolution specialists.

• Attend necessary seminars and workshops.

• Travel occasionally as needed.

• Undertake additional duties and special assignments to meet business requirements.

⛳️ Requirements

• Must reside and work in one of the eligible U.S. states: Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, New Hampshire, New Jersey, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia, or Wisconsin.

• College degree or equivalent experience is required.

• Significant experience as a claims resolution specialist or in a related field is necessary.

• Strong comprehension of insurance principles and the claims organization.

• Exceptional negotiation, communication, and investigative skills for telephone and personal claims interactions.

• Familiarity with tort law is essential.

• Comprehensive knowledge of medical terminology and treatments.

• Ability to obtain, analyze, and assess medical history and documentation.

• Detail-oriented with strong organizational skills.

• Proven track record of evaluating serious and complex injury claims and successfully negotiating outcomes.

• Excellent understanding of all personal and commercial lines policies and coverages offered by the company.

• Obtain state licensing as required.

• Continuing education through AIC and/or CPCU designations or other accredited insurance education providers is highly preferred.

🏝️ Benefits

• Bonus opportunities.

• Health, Dental & Vision Insurance coverage.

• Company-sponsored life and income protection plans.

• Eligibility to participate in a company incentive bonus program.

• 401(k) Retirement Plan with 100% company match up to 7% of annual salary.

• Paid Time Off, Paid Holidays, and Floating Holidays.

• Flexible Work Arrangements, including hybrid and remote options based on the role.

• Opportunities for professional growth and learning.