Complex Claims Specialist (Remote)

At Selective, we don't just insure uniquely, we employ uniqueness. 

Our Business  

Selective is a midsized U.S. domestic property and casualty insurance company with a history of strong, consistent financial performance for nearly 100 years. Selective's unique position as both a leading insurance group and an employer of choice is recognized in a wide variety of awards and honors, including listing in Forbes Best Midsize Employers in 2024 and certification as a Great Place to Work^® in 2023. 

Working at Selective 

At Selective, we don't just insure uniquely – we employ uniqueness. Employees are empowered and encouraged to Be Uniquely You by being their true, unique selves and contributing their diverse talents, experiences, and perspectives to our shared success. Together, we are a high-performing team working to serve our customers responsibly by helping to mitigate loss, keep them safe, and restore their lives and businesses after an insured loss occurs.  

Selective Insurance offers a total rewards package that includes a competitive base salary, incentive plan eligibility at all levels, and a wide array of benefits designed to help you and your family stay healthy, achieve your financial goals, and balance the demands of your work and personal life. These benefits include comprehensive health care plans, retirement savings plan with company match, discounted Employee Stock Purchase Program, tuition assistance and reimbursement programs, and paid time off plans. Additional details about our total rewards package will be provided during the recruiting process. 

Click to learn more about the Selective Claim Culture and why Selective is right for YOU!  https://youtu.be/zuF1YgAyQfo

Selective Insurance is seeking a Complex Claims Specialist who will work remotely to provide direct handling of the company’s most complex and challenging claims. Responsibilities of this position include coverage analysis, investigation, evaluation, negotiation and disposition of assigned claims. Candidate must possess strong litigation management skills to aggressively manage litigation activities, budgets and claim outcomes while considering the overall impact to the customer and company. The individual in this position will also ensure claims are processed within company policies, procedures, and within individual's prescribed authority with exceptional standards of performance. This individual should possess strategic though process skills to effectively and efficiently manage loss exposures. Job duties will include communication and collaboration with key stakeholders, training, development and providing thought leadership where requested. In addition, position may require travel to mediations, arbitrations, settlement conferences, trials or other proceedings which may account for up to 25% of the specialist time.

JOB RESPONSIBILITIES:

• Effectively evaluate and resolve coverage issues for all lines of business and all liability claim types.
• Investigate the claims through telephone, written correspondence, and/or personal contact with claimants, attorneys, insureds, witnesses and others having pertinent information.
• Effectively and efficiently manage vendors and expenses.
• Timely analyze information in order to evaluate assigned claims to determine the extent of loss, taking into consideration contributory or comparative negligence. Assign medical or other experts to case and arrange for medical examinations when necessary.
• Effectively evaluate, negotiate and resolve claims within delegated authority (ranging from $100,000 to $400,000) utilizing the appropriate denials or releases.
• Provide required reports to claims, underwriting, reinsurance and actuarial on significant exposure cases.
• Report on all cases going to trial on a timely basis and attend portions of trials when warranted or where requested by management.
• Ensure proper referrals and timely updates to appropriate Reinsurer(s).
• Ability to handle or oversee Extra-Contractual, EPLI, Social Services and E&O claims against the Company.
• Must be able to drive an automobile to travel within territory. Car travel represents approximately 25% of employee’s time and a valid driver’s license.

JOB QUALIFICATIONS:

• College degree preferred.
• 8+ casualty claims handling experience (of those, a minimum of 5 years handling cases of a complex nature with a primary P&C carrier).
• Knowledge of New York Labor Law required.
• Experience in complex coverage analysis and significant large loss evaluations.
• Superior communication and strategic negotiation and claim disposition skills along with proven problem-solving skills;
• Excellent presentation skills;
• Moderate proficiency with standard business-related software (including Microsoft Outlook, Work Excel, and PowerPoint.
• Sufficient keyboarding proficiency to enter data accurately and efficiently
• Multi-State licensing with strong understanding of Medicare reporting & compliance preferred.
• Must have valid state-issued driver’s license in good standing and be able to drive an automobile.
• Law degree preferred but not required.

The expected starting salary range for this role is $106,000 - $167,000.  The actual base salary is based on geographic location, and the range is representative of salaries for this role throughout Selective's footprint. Additional considerations include relevant education, qualifications, experience, skills, performance, and business needs. 

Selective is an Equal Employment Opportunity employer.  That means we respect and value every individual’s unique opinions, beliefs, abilities, and perspectives. We are committed to promoting a welcoming culture that celebrates diverse talent, individual identity, different points of view and experiences – and empowers employees to contribute new ideas that support our continued and growing success. Building a highly engaged team is one of our core strategic imperatives, which we believe is enhanced by diversity, equity, and inclusion. We expect and encourage all employees and all of our business partners to embrace, practice, and monitor the attitudes, values, and goals of acceptance; address biases; and foster diversity of viewpoints and opinions. 

Selective maintains a drug-free workplace. 

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