Job Title: Senior Complex Claims Technical Specialist
Job Responsibilities:
- Adjudicate highly complex claims and insurance coverage disputes at the highest authority limits, working with limited oversight under broad management direction.
- Conduct detailed information gathering, analysis, and investigation to resolve issues that are numerous and undefined.
- Oversee defense panelists, monitor and evaluate their operations and performance.
- Conduct file reviews to ensure accuracy, attend mediations and settlements, and participate in pre-trial calls as necessary.
- Provide technical guidance in properly setting claim reserves.
- Report to senior management and underwriters on insurance coverage issues and claims trends and developments.
- Investigate insurance coverage issues and claims promptly and thoroughly, including interviewing all involved parties.
- Manage claims in litigation and ensure timely resolution for the best financial outcome.
- Identify and coordinate expertise resources to assist in case resolution.
- Prepare reports for file documentation and apply creative solutions for the best financial outcome.
- Negotiate highly complex settlement packages, set reserves, and authorize payment within scope of authority.
- Process mail, prioritize workload, and complete telephone calls and written correspondence.
- Demonstrate strong claim management skills and passion.
Education and Experience Information:
- . from an accredited law school.
- A minimum of seven years’ experience adjudicating claims and/or insurance coverage disputes with exposure of $100,000 or more.
- At least seven years’ experience handling insurance coverage issues and disputes, including under policy types such as Commercial General Liability, Garage, Inland Marine, Excess, Property, and Environmental.
- Good business acumen and understanding of how an insurance company works and makes money.
- Ability to regularly exercise discretion and independent judgment with respect to significant matters.
- Excellent communication skills, ability to build lasting relationships, and desire to work in a fast-paced environment.
- Strong evaluation, strategic, and claim negotiation skills.
- Proficient in MS Office Suite and other business-related software.
- Licensed Claims Examiner or willingness to quickly obtain a license in each jurisdiction requiring a license to adjudicate first-party claims within 120 days.
Salary Information:
The base salary range provided is specific to certain geographic areas and will be commensurate with candidate experience. Pay ranges for candidates in other locations may vary based on the cost of labor in that location. In addition to base salary, employees are eligible for an annual bonus based on company and individual performance, as well as a generous benefits package.
- New York City metro area Pay Range: $185,600 - $223,100
- Chicago and Los Angeles metro area Pay Range: $170,300 - $204,300
Additional Information:
- The role generally operates within a standard office environment requiring the use of a PC and other related office equipment.
- The company is a leader in specialty insurance with a culture built on respect, equality, wellness, and opportunity.
- The company encourages a collaborative workplace where all employees feel comfortable, confident, and recognized for their performance.
- The company is committed to creating an inclusive culture that embraces diversity and design thinking, promotes collaborative service delivery, and recognizes excellence.
- Employees at the company thrive in a responsible, profitable specialty insurer environment where all stakeholders share in success.
- The company offers a Total Rewards package that includes competitive compensation, workplace policies supporting well-being, comprehensive health and financial planning options, professional development opportunities, and community outreach programs.
- The company is an Equal Opportunity Employer and does not tolerate discrimination or harassment based on any protected characteristics.
