Specialty Casualty Claims Specialist

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

📋 Description

• Oversee intricate litigated casualty claims from the initial investigation to final resolution.

• Evaluate coverage, liability, damages, contracts, statutes, and policy language to assess claim exposure.

• Formulate litigation strategies in collaboration with defense counsel, including analysis of lawsuits, action plans, and settlement suggestions.

• Negotiate settlements with claimants, plaintiff attorneys, insured individuals, and other involved parties.

• Participate in and supervise trials, depositions, mediations, arbitrations, and various litigation proceedings.

• Establish, monitor, and modify reserves; create large loss reports and present complex cases during claims roundtables.

• Prepare reservation of rights, coverage position, and denial letters while ensuring adherence to regulatory standards.

• Direct investigations by collecting statements, reviewing reports, preserving evidence, and coordinating with attorneys, experts, and vendors.

• Identify recovery opportunities, manage liens such as Medicare, and pursue subrogation and other cost-recovery initiatives.

• Examine legal budgets, invoices, estimates, and vendor expenses for precision and cost-effective claim resolution.

• Act as a technical expert and mentor for claims professionals.

• Collaborate with Underwriting, Risk Improvement, Legal, SIU, Medical Review, and other internal teams to assess risk exposures and achieve outstanding claim outcomes.

⛳️ Requirements

• Bachelor's degree or equivalent relevant experience.

• Eight years of experience in casualty claims adjusting or related fields.

• Minimum of four years of experience in the designated specialty line of business.

• Experience with Public Entity, EPLI, E&O, and/or Law Enforcement claims is highly desirable.

• Relevant insurance designations are preferred.

• Strong understanding of best practices in handling serious and complex liability claims.

• Advanced knowledge of insurance contracts, medical terminology, and substantive and procedural laws.

• Proficient in computers and claims management systems.

• Ability to obtain all necessary state licenses.

• Commitment to high standards of professional conduct and ethical codes.

• Exceptional organizational skills and empathetic interpersonal abilities.

• Strong written and verbal communication skills.

• Advanced customer service capabilities.

• Ability to maintain confidentiality.

• Strong investigative and problem-solving skills.

• Occasional travel may be required.

• Valid driver's license with an acceptable motor vehicle record per company standards is required if driving.

🏝️ Benefits

• Comprehensive rewards package; details about benefits can be found at www.emcins.com/careers.

• Option to work from home anywhere in the United States.

• Tobacco-free workplaces and company vehicles.