Senior Claims Specialist

Job Title

Managing complex and/or catastrophic claims within all jurisdictions.

Job Description

This position is responsible for managing complex and/or catastrophic claims within all jurisdictions. This includes investigation, evaluation, and resolution of claims. Interface with underwriting, risk management, case management, clients, and vendors as appropriate in controlling costs and loss ratios and providing the claimant with appropriate care. Provide leadership of day to day activities on large loss and catastrophic claims.

Key functions include but are not limited to the following:

• Oversee catastrophic and large loss claims from beginning to resolution.
• Manage all technical aspects of claims including coverage, disability benefit management, medical management, file management, litigation management, subrogation, reserving and settlement.
• Verify and interpret coverage issues.
• Consult with attorneys, assist in negotiation of settlement, mediations and trials (attend trials as necessary).
• Resolve problems involving multi-faceted claims handling.
• Investigate, evaluate, and negotiate claims toward resolution and provide medical needs within jurisdictional guidelines and Berkley Industrial Comp philosophies.
• Determinate appropriate reserves to adequately reflect exposure of losses.
• Attend and participate in training sessions to the accounts or account visits and claim reviews.

Qualifications

• Bachelor's degree with concentration in law, public administration, business, nursing or insurance OR equivalent work experience.
• 7+ years of experience adjusting workers' compensation claims with significant experience handling Workers' Compensation claims. Ten (10) years' experience preferred.
• Experience in catastrophic and/or large losses preferred.
• Possess and maintain a professional adjusting license in all jurisdictions applicable or obtained within one year of job acceptance.
• Strong interpersonal, analytical, and negotiation skills

Additional Company Details

We do not accept any unsolicited resumes from external recruiting agencies or firms. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.

Sponsorship Details

Sponsorship not Offered for this Role