Job Description
Investigates, evaluates, disposes and settles the most complex claims and highest exposures with minimal supervision. Includes the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves.
Incumbents at this level typically hold claims reserve and settlement authority of up to $10,000 liability and / or $25,000 workers compensation or greater.
Analyzes coverage and settles moderately complex claims in one or more of specialty claims areas.
Generally, incumbent does not work on workers compensation claims.
Able to manage the full-life cycle of all assigned claims files. Analyzes coverage and determines defense obligations.
Under minimal supervision, conducts thorough analysis and investigations necessary to determine claims exposure and recommend appropriate settlement strategies and action plans.
Creates reservation of rights and coverage denial letters.
Negotiates settlements with clients, client attorneys, and Public Adjusters.
Interacts extensively with various parties involved in the claims process, and may recommend retaining the advice of outside experts as necessary.
Prepares reserve and settlement authority requests for client and carrier approval.
May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage.
Has a solid understanding of claims processing and the insurance brokerage business.
Has a basic understanding of the terminology and case law associated with their specialized claims niche / industry.
Handles claims consistent with clients' and corporate policies, procedures and best practices and also in accordance with any statutory, regulatory and ethical requirements.
Incumbents at this level should be able to work at full case load capacity.
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day.
We are an equal opportunity / affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances.
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Required Skills & Experience
Appropriately licensed and / or certified in all states in which claims are being handled.
Knowledge of accepted industry standards and practices.
Computer experience with related claims and business software.
Must have 7+ years General Liability claims experience
Ability to successfully negotiate the settlement and disposition of claims including the ability to interpret related documentation
5+ years Soft to complex Bodily Injury claim experience
oDirect BI settlements with unrepresented claimants, as well as attorney represented
Commercial Property damage experience
Commercial Auto / Trucking experience
5+ years with heavy complex Litigation experience
oTender requests, Tenders out to others, Coverage experience
Experience with attorney representative files
Nice to Have Skills & Experience
Bachelors degree
NY Adjuster License
Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching.
Employees in this role are also entitled to paid sick leave and / or other paid time off as provided by applicable law.