Offer summary

Qualifications:

Bachelor's degree from a four-year college or university, JD preferred., 10 years of claims experience managing excess insurance claims., Strong written and oral communication skills, with experience in contract/policy review., Proficiency with Microsoft Office and ability to work with minimal supervision..

Key responsibilities:

Investigate, evaluate, and dispose of Excess claims independently.

Prepare reports and document investigations to ensure timely file management.

Negotiate settlements and adjust reserves within authority levels.

Direct and monitor activities of defense counsel and attend necessary legal proceedings.

Job description

The Senior Claim Specialist - Excess works independently to provide claim-loss service for Coverys policyholders including investigating, evaluating and disposing of Excess claims. This role focuses on claims with high levels of complexity and severity and operates as the subject matter expert on all Excess claims. Under the direction of the Director, Claims, the Senior Claim Specialist operates as a technical leader of the Excess claims function, including building and evaluating applicable policies and procedures and influencing and guiding team members.

Essential Duties & Responsibilities

Interview insureds, claimants, witnesses, and other appropriate parties to obtain information used to assess liability exposure.
Analyze and verifies insurance coverage for claims brought against policyholders. Consult with coverage counsel as appropriate.
Document file regarding results of investigation and negotiations.
Prepare reports to file on established diary dates and other specific reports as needed to ensure timely file documentation and plan of action.
Secure records for investigation and evaluation of cases.
Determine and implement negotiation strategy and negotiate settlements within authority level.
Adjust reserves within level of authority and make reserve recommendations to Manager/Director for amounts over position authority level.
Evaluate cases for appropriate disposition and seek authority for settlement from manager/director when settlement amount requests exceed authority.
Direct and monitor activities of defense counsel in compliance with Case Management Guidelines.
Monitor trials and attend pre-trial proceedings, mediations, and arbitrations as necessary.
Identify significant insured Risk Management or Underwriting issues and direct the information to appropriate department.
Communicate with insureds, claimants, and witnesses; consult medical and other relevant records, varying methods of investigation according to type of claim.
Analyze losses to determine if insurance coverage applies.
Maintain working knowledge of policy forms and can confirm policy in effect for date of loss.
Serve as the Excess consultative resource for development & growth of fellow claim professionals and/or new team members.
Demonstrate effective collaboration with core business units such as UW, Risk Management & Business Development.
Performs other duties as assigned and may be asked to work on special projects or participate in interdepartmental work groups upon request.

Education, Experience, Competencies & Values

Bachelor's degree from four-year college or university, JD preferred.
10 years claims experience managing excess insurance claims.
Insurance adjuster's license may be required for specific states.
Knowledge of medical, legal and insurance terminology is required.
Strong written and oral communication skills. Must be comfortable making oral presentations to staff and insureds.
Must have experience in contract/policy review and application.
Able to organize, prioritize, communicate and meet established deadlines.
Ability to read, analyze, and interpret insurance policy coverage forms, professional journals, technical procedures, or government regulations. Ability to write reports, business correspondence, and technical case summaries. Ability to effectively present information and respond to questions from groups of managers, insured's, agents and attorneys.
Must be able to synthesize complex or diverse information; collect and research data; use intuition and experience to complement data; design workflows and procedures.
Must have the ability to design and generate creative solutions.
Proficiency with Microsoft Office.
Able to work with minimal supervision on a day-to-day basis.
Must hold a current driver's license.
Travel as needed to regional claims offices, customer locations, and trials, mediations, and/or settlement conferences. Travel approximately 10%.

The base salary range is $113,000 - $153,300. Individual compensation packages are based on a variety of factors that are unique to each candidate including geographic location, skill set, experience, qualifications and education.

If you're a caring and customer focused individual who enjoys working with passionate team members, Coverys is the right company for you!

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