Technical Claims Specialist
Directly handles and/or assists in monitoring, reviewing and coordinating the activities involving workers compensation and general liability claims. Performs due diligence on potential acquisition target to ensure claims are properly reserved.
Business Line Responsibilities:
- Works with and assists Business Development Team to evaluate claim level reserves of potential acquisitions. Review includes primarily workers compensation claims and other long tail exposures..
- Ensures proper file setup, reserving, general handling and application of company procedure and coverage interpretation philosophy on newly acquired business.
- Manages various Third Party Administrators handling of the Company’s workers compensation claims.
- Manages the review of loss notices; confirms and interprets policy coverage’s; establishes adequate reserves; and investigates and handles claims involving primary, excess, and umbrella coverage’s.
- Provides specific claims information to senior management relative to all new notices of loss and maintains specific financial and general statistical records which are used for reporting to management.
- Manages and participates in the diary control of reported cases to ensure maintenance of proper reserves to reflect the company’s exposure and adequate notice to reinsurers, and recovery of specific amounts when payment exceeds the company’s retention.
- Ensures claim data in Claim Reporting System is kept up to date and accurate.
- Participates in conversion of claim systems when and if needed.
- Participates in Audits relating to assigned claims portfolio.
- Assist R&Q Companies in special project efforts.
Skills, Abilities and Job Knowledge Required:
- Capable of working in a small office environment.
- Capable of working independently and meeting assigned deadlines.
- Ability to analyze, interpret and write professional documents.
- Able to accurately and effectively respond to internal and external inquiries and/or complaints.
- Comfortable with presenting information to corporate executive level.
Qualification and Experience Required:
- College Degree or Equivalent Experience.
- Minimum 7 – 10 years’ experience in handling workers compensation, general liability and/or latent exposure claims or a legal degree with at least (3) years claims handling experience.
- Limited physical exertion required (lifting heavy files)
- Required to sit for long periods of time.
- Usual office work conditions.
- Limited travel not anticipated to exceed 5-6 trips annually
This job description does not represent an employment contract, nor is it all-inclusive. Employees may be required to perform other duties as requested, directed or assigned.