Senior Claims Specialist – Professional Liability

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

📋 Description

• Analyze complex errors and omissions, as well as claims related to directors and officers.

• Provide resolutions for claims of a highly complex nature and/or those involving severe injuries.

• Coordinate case management in accordance with Company standards, industry best practices, and specific client service requirements.

• Manage total claim costs while ensuring high levels of customer service.

• Conduct or assign comprehensive investigations and provide reports related to new events, claims, and legal actions.

• Negotiate claim settlements up to the designated authority level.

• Calculate and assign timely and appropriate reserves for claims, monitoring reserve adequacy throughout the claim's lifecycle.

• Recommend settlement strategies and present structured settlement proposals as necessary to optimize outcomes.

• Coordinate legal defense by assigning attorneys, facilitating support for investigations, and reviewing attorney invoices; ensure counsel compliance with client guidelines.

• Implement appropriate cost containment techniques, including strategic vendor partnerships, to lower overall claim costs for our clients.

• Identify and investigate potential fraud, subrogation, contribution, recovery, and case management opportunities to minimize total claim costs.

• Represent the Company in depositions, mediations, and trial monitoring as required.

• Communicate claim activities and processing with clients while maintaining professional relationships.

• Ensure that claim files are accurately documented and that claims coding is correct.

• Refer cases to supervisors and management as necessary.

• Delegate tasks and mentor assigned staff.

• Perform other duties as assigned.

⛳️ Requirements

• A minimum of six (6) years of claims management experience or an equivalent combination of education and experience is required.

• A bachelor's degree from an accredited college or university is preferred.

• Licenses as required.

• Professional certification relevant to the line of business is preferred.

🏝️ Benefits

• Flexible work schedule.

• Referral incentive program.

• Opportunities for career development and promotional growth.

• A diverse and comprehensive benefits package including medical, dental, vision, and 401K starting on day one.