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Claims Specialist III - MCU

$103k - $136k
Full-time

UFG Insurance

UFG is currently hiring for a Claims Specialist III to work within our Complex Claims team. This is a senior level technically advanced position responsible for claim decisions and actions that promote high quality, efficient and cost-effective representation of our insureds and UFG in complex and high exposure litigated matters, involving complex coverage issues. In addition, this position may be responsible for compliance with technical large loss management and reporting on his or her files.

This position investigates, evaluates, negotiates and resolves high complexity litigated casualty claims involving designated categories of complexity including, but not limited to, pollution claims, mass tort claims, BIPA, sexual harassment, employment practices claims, professional liability claims, class actions, and litigated coverage matters. This position requires extensive experience in litigated casualty claims, superior analysis and negotiation skills, and effective and efficient litigation management skills. This position is responsible for conducting timely and thorough investigations, verifies applicable coverages, vets and retains appropriate defense counsel, analyzes liability, evaluates damages for reserve and settlement, and implements litigation management practices in accordance with claims best practices.

The Complex Claims Specialist III position requires strong soft skills and technical skills, strong communication skills, attention to detail, and the ability to handle multiple tasks efficiently and effectively. It also requires the ability to work independently with low level of supervision and high level of accountability. A strong desire to advance one’s professional development is essential to this role.

Essential Duties & Responsibilities:

  • Review new claims assignments to determine the nature of the claim and action required.
  • Secure a complete copy of the notice materials and complaint, if in litigation, and review to determine UFG’s obligations in connection with the claim. If coverage issues are present, draft appropriate coverage position letter.
  • On primary files:
  • Conduct investigation and determine if an attempt to resolve the suit prior to assignment to defense counsel is appropriate.
  • Vet and retain appropriate defense counsel for the claim, if there is a duty to defend.
  • Collaborate with defense counsel on case strategy and action plan, documented in the lit plan and budget.
  • Actively manage the claim file and defense counsel to execute on the agreed plan, proactively pushing the claim to resolution.
  • Document all file activity through detailed file notes and prepare reports for the claim file per claims best practice guidelines.
  • Evaluate damages and recommend reserves per reserve timeliness and accuracy guidelines.
  • Develop and execute negotiation strategies and proactively push claims towards resolution.
  • Actively identify subrogation potential and posture claim for successful subrogation recovery.
  • Identify risk transfer opportunities and exposures. Draft tender letters and place all potential parties on notice.
  • Work with defense counsel in vetting, selecting and retaining experts when necessary. Be constantly aware of and apply expense management initiatives.
  • Notify insured of key developments and demands throughout the case and communicate with the agency and underwriting regarding significant shifts in exposure.
  • Review fee statements and negotiate adjustments in accordance with UFG billing guidelines.
  • On litigated coverage files:
    • Retain and manage outside coverage counsel
    • Vet coverage positions to be taken in the DJ and escalate to in-house legal as needed.
    • Evaluate and understand coverage issues that are present.
    • Communicate DJ developments to the underlying adjuster and management in coordination with outside coverage counsel.
    • Assist outside coverage counsel in obtaining the necessary file materials to effectively defend or prosecute the coverage action.
    • Assist outside counsel in responding to discovery.
  • Inform underwriting of increased hazards or unusual circumstances concerning a risk or policy exposure.
  • Participate in company sponsored educational programs and other educational opportunities to develop knowledge and skill.
  • Participate in various claims committees to drive claims initiatives.
  • Demonstrate a supportive attitude and presence within the team by adapting well to change in process or procedure. Share innovative ideas to improve work product and outcomes. Take initiative to identify and learn about areas of professional development. Proactively seek out opportunities to collaborate with peers.
  • Mentor other Claim Specialists to further their development and technical skills.
  • SME for coverage analysis, risk transfer, AI and tenders, liability analysis, reserve and settlement evaluation, negotiation, and defense strategy.
  • Provide technical training to their teams.

Job Specifications:

Education:

  • Bachelor’s degree preferred.
  • Law degree preferred.

Licensing/Certifications/Designations:

  • Meet the appropriate state licensing requirements to handle claims.
  • CPCU, AIC, SCLA or Legal Principles, CCLA and PCLA of the AEI series preferred.

Experience:

  • 10+ years of casualty claims experience.

Skills & Abilities:

  • Ability to read, comprehend and interpret policy language, endorsements, and contracts while applying them to the claim.
  • Analytical ability to determine coverage, risk transfer, liability, and bodily injury/property damage evaluation for reserves and settlement.
  • Must possess strong negotiation skills, human relations skills, analytical skills, organization skills as well as oral and written communication skills.
  • Ability to concisely document information into appropriate file notes and reports.
  • Strong negotiation skills direct with attorneys, as well as effective mediation and arbitration techniques.
  • Demonstrate aptitude for mentorship / leadership.
  • Proactive management of defense counsel and expense management.
  • Service-Oriented Mindset
  • Clear and Concise Communication
  • Analytical and Critical Thinking
  • Attitude of Collaboration and Curiosity
  • Proactive Decision-making and Problem-solving
  • Proven Effective Negotiation Approach
  • Time management and Sense of Service Urgency
  • Mentoring and development.
  • Polished presentation skills and ability to present and articulate claims to committee.

Working Conditions:

  • Working remote from home or general office environment.
  • Frequently the job requires working irregular hours.
  • Occasional overnight travel and weekend hours may be required.

Pay Transparency Statement:

UFG Insurance is committed to fair and equitable compensation practices. The base salary range for this position is $103,000 - $136,000 annually, which represents the typical range for new hires in this role. Individual pay within this range will be determined based on a variety of factors, including relevant experience, education, certifications, skills, internal equity, geography and market data.

In addition to base salary, UFG Insurance offers a comprehensive total rewards package that includes:

  • Annual incentive compensation
  • Medical, dental, vision & life insurance
  • Accident, critical Illness & short-term disability insurance
  • Retirement plans with employer contributions
  • Generous time-off program
  • Programs designed to support the employee well-being and financial security.

This pay range disclosure is provided in accordance with applicable state and local pay transparency laws.

Vacancy posted 1 day ago
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