Complex Casualty Senior Claims Resolution Specialist - Southeast Region
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Responsible for the investigation, evaluation and disposition of cases on assignment, which may include an established portion of the office/team workload and/or individual assigned cases that present moderate to high exposure or complex coverage or liability issues.
This position is eligible for up to a $2,500 sign on bonus for candidates with an active adjuster's license.
- Manages, investigates, and resolves claims. Investigates and evaluates coverage, liability, damages, and settles claims within prescribed authority levels.
- Recommends ultimate resolution on assigned cases in excess of their authority to local claims management and Home Office.
- Identifies potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation.
- Prepares for and attends trials, hearings and conferences and reports to Home Office and local management on status.
- Confers with trial counsel and prepares trial reports.
- Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to proper course of action.
- Responds to various written and telephone inquiries including status reports.
- Ensures adequacy of reserves.
- Recommends reserve increases on cases in excess of authority.
- Accountable for security of financial processing of claims, as well as security information contained in claims files.
- Responsible for managing the practices and billing activities of outside and in-house counsel.
- May assist in the absence of the Claims Team Manager, representing the company on matters involving state or federal regulatory agencies.
- May be involved in special projects and/or mentoring at the direction of local management.
- Must have an advanced knowledge of coverage, liability, and complex claims handling procedures.
- Must be knowledgeable of state and federal laws in the adjuster's jurisdiction.
- A full working knowledge of claims operations and procedures is required.
- Strong written and oral communication skills required as well as strong interpersonal, analytical, investigative, and negotiation skills.
- The capabilities, skills and knowledge required is normally acquired through a Bachelor's degree or equivalent experience and at least 5-7 years of directly related experience.
- Ability to obtain proper licensing as required.