Claims Specialist

Claims Specialist

The Claims Specialist investigates, evaluates, negotiates, and resolves litigated and non-litigated property damage, personal and advertising injury, and claims of medium exposure and complexity. This individual will work under limited supervision, with a remote manager.

Key Functions:

• Analyze coverage, identify coverage issues, and prepare coverage letters for supervisor approval
• Investigate and evaluate liability
• Investigate and evaluate damages
• Manage litigation by assigning counsel from the approved panel where applicable, establish litigation plan and budget, coordinate with defense counsel, and continuously review the potential for resolution.
• Establish timely reserves within authority and re-evaluate throughout the life of the claim
• Maintain up-to-date, appropriate file documentation and written file notes
• Maintain an active diary and productive file inventory
• Timely completion of all required large loss reporting
• Negotiate settlements within authority limit granted, and attend mediations, mandatory settlement conferences, and/or alternative dispute resolutions
• Proactively control the work product and expense of outside vendors
• Develop and maintain positive customer relationships and provide superior customer service
• Timely identify all potential opportunities for co-insurance, transfer of risk and/or subrogation
• Ability to Work with designated assigned accounts
• Recognize and investigate fraud
• Comply with deductible/self-insured retention recovery protocol
• Meet and maintain all state licensing requirements at all times (see qualifications below)
• Adhere to all statutory regulations, unfair claims practices acts, and corporate best practices
• All other duties as assigned

Qualifications

• Four (4) year college degree, or commensurate experience and training
• AIC, SCLA, CRIS or other similar industry designations preferred
• 3-5 or more years claims handling experience or equivalent experience
• In-depth knowledge of the insurance industry, including legal and regulatory environments
• A strong functional and developing knowledge of substantive laws and legal procedure
• Applicable adjusters license(s) to include: CA, CT, DE, FL, KY, LA, NH, NM, NC, OK, RI, SC, TX, VT, WV, WY

Sponsorship Details

Sponsorship not Offered for this Role