Job Title: Complex Claims Consultant (Community Association D&O Liability)
Job Responsibilities:
- Manage an inventory of highly complex commercial claims with substantial exposures, requiring specialized technical expertise and coordination. This involves verifying policy coverage, conducting investigations, developing resolution strategies, and authorizing disbursements within authority limits.
- Ensure exceptional customer service by interacting professionally, achieving quality and cycle time standards, providing timely updates, and responding promptly to inquiries and requests for information.
- Verify coverage and establish timely and adequate reserves by reviewing and interpreting policy language, partnering with coverage counsel on complex matters, estimating potential claim valuation, and adhering to company protocols.
- Lead focused investigations to determine compensability, liability, and covered damages by gathering pertinent information, taking recorded statements, and working with experts or other parties as necessary to verify facts.
- Resolve claims by collaborating with internal and external business partners to develop a claim resolution strategy. This includes managing timely and adequate reserves, negotiating complex settlements, partnering with counsel to manage complex litigation, and authorizing payments within scope of authority.
- Establish and manage claim budgets by achieving timely claim resolution, selecting and overseeing appropriate resources, authorizing expense payments, and delivering high-quality service efficiently.
- Identify and address subrogation/salvage opportunities or potential fraud by evaluating claim facts and making referrals to appropriate resources for further investigation.
- Achieve quality standards by managing each claim appropriately to ensure company protocols are followed, work is accurate and timely, files are properly documented, and claims are resolved and paid timely.
- Keep senior leadership informed of significant risks and losses by completing loss summaries, identifying claims for oversight/watch lists, and preparing and presenting summaries to senior management.
- Maintain subject matter expertise and ensure compliance with state/local regulatory requirements by following company guidelines and staying current on commercial insurance laws, regulations, or trends for the line of business.
- Mentor, guide, develop, and deliver training to less experienced Claim Professionals.
Education & Experience:
- Bachelor’s Degree or equivalent experience required; Juris Doctor preferred.
- Typically a minimum of six years of relevant experience, preferably with Professional Liability or Directors & Officers claims handling.
- Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.
- Prior negotiation experience is essential.
- Professional designations such as CPCU are a plus.
Salary Information:
- In Illinois/New York/California, the average base pay range for a Complex Claims Specialist/Consultant is $83,000 to $160,000. Salary determinations are based on factors including relevant work experience, skills, certifications, and location.
- In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York, and Washington, the national base pay range is $72,000 to $141,000 annually. Salary determinations are based on factors including work experience, skills, certifications, and location.
- The company offers a comprehensive and competitive benefits package to support employees and their family members in achieving physical, financial, emotional, and social wellbeing goals.
Skills, Knowledge & Abilities:
- Thorough knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.
- Demonstrated expertise in effectively communicating with policyholders, skillfully explaining coverage issues, the litigation process, and the benefits of early resolution.
- Proven ability to develop and execute effective negotiation strategies and successfully resolve complex disputes creatively.
- Strong communication and presentation skills, both verbal and written, including the ability to communicate business and technical information clearly.
- Demonstrated analytical and investigative mindset with critical thinking skills and ability to make sound business decisions and effectively evaluate and resolve complex business problems.
- Strong work ethic with demonstrated time management and organizational skills.
- Ability to work in a fast-paced environment at high productivity levels.
- Experience interpreting complex commercial insurance policies and coverage.
- Ability to manage multiple and shifting priorities in a challenging environment.
- Proficiency in Microsoft Office Suite and ability to learn business-related software.
- Demonstrated ability to value diverse opinions and ideas.
Note: The company is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process.
