Senior Claims Resolution Specialist, Complex Casualty - MidAtlantic (Auto and Homeowner's)
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Responsible for the investigation, evaluation and disposition of complex casualty 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.
Candidates residing remotely will be considered, however, the ideal candidate will reside in one of our MidAtlantic locations (NJ, PA,CT, VA, MD, RI, DC, DE, WV).
- 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 litigation, 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.
- Casualty/bodily injury experience with increasing complexity of cases and personal authority.