Senior Claims Specialist- Financial Lines

Job Description

Job Summary

The Claims Specialist works on highly complex claim assignments requiring specialized knowledge. The role handles activities including, but not limited to, coverage analysis, liability and damage investigation, litigation, and expense management. The role also evaluates claims for reserve and settlement, executes settlement strategy, negotiates settlements proactively, attends arbitrations and ensures appropriate file documentation.

Duties and Responsibilities:

• Directly handle, manage and/or oversee financial lines fidelity and crime claims, and financial institution E&O and D&O claims.
• Handle claims in accordance with Claim Handling Best Practices in all phases of the claim including through initial contact, investigation of the claim, evaluation the claim for coverage and reserving for exposure, and in the resolution and documentation of claims.
• Provide top-notch customer service through all interactions and communications including with internal and external customers and business partners.
• Review and evaluation of policies to determine coverage.
• Resolve coverage-related matters working collaboratively with outside counsel when necessary.
• Complete written reports and present claims to management, underwriting, actuary and reinsurers on claim developments as needed.
• Adhere to all statutory regulations and Unfair Claims Practices Acts.
• Consistently communicate claim developments, exposure analyses and requests for authority to claims management.
• Participate in mediations, settlement conferences and otherwise see claims through to resolution.
• Work closely with underwriting and other business partners to review, analyze, and communicate claim trends and help develop policy language.
• Along with underwriting, attend current and prospective meetings with insureds and brokers.
• Work with and manage outside vendors, including outside attorneys to manage budgets and oversee litigation.

Qualifications:

• Minimum of 3 to 6 years of experience at either a specialty insurance carrier and/or law firm.
• Significant fidelity, crime, and financial institutions E&O and D&O experience
• Bachelor's degree and Juris Doctor from an accredited law school required.
• Candidates will be required to obtain and maintain insurance adjuster licenses.
• Excellent written communication skills.
• Excellent verbal and interpersonal communication skills, resulting in the ability to interact with all levels of management and employee population.
• Strong analytic, investigative, listening and negotiation skills.
• Experience multi-tasking, prioritizing work and working effectively in a team environment, while maintaining attention to detail.
• Experience working in a fast-paced environment, completing work with limited supervision.
• Experience with Microsoft Windows, Outlook, and Excel or transferable software packages.
• Ability and willingness to travel as needed.

Licenses and Certifications

• Certified Professional Claims Management (CPCM) (preferred)
• Certified Claims Adjuster (CCA) (preferred)
• Chartered Property Casualty Underwriter (CPCU) (preferred)

Behavioral Competencies

• Collaborates
• Communicates Effectively
• Customer Focus
• Decision Quality
• Nimble Learning

Technical Skills

• Account Management
• Claims Investigations
• Claims Adjustment
• Claims Resolution
• Claims Settlement
• Financial Controls
• Auditing
• Claims Case Management
• Customer Relationship Management
• Business Process Improvement
• Auditing
• Data Analysis and Reporting

This job description describes the general nature and level of work performed in this role. It is not intended to be an exhaustive list of all duties, skills, responsibilities, knowledge, etc. These may be subject to change and additional functions may be assigned as needed by management.

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