Sr. TPA Specialist, Complex Claims

Zurich Insurance is currently looking for a Sr TPA Specialist. This position will oversee complex Liability claims handled by external TPAs on behalf of Zurich insureds and Captives nationwide. This supervisory oversight position works with minimal direction at high authority levels on assignments reflecting technical complexity. The position requires excellent technical skills as well as product and industry knowledge and is recognized as a technical consultant and advisor both within and outside the company. The Sr TPA Specialist analyzes highly complex coverage situations, evaluates high exposure claims, seeks/grants authority, assigns/explains reserves to senior management and customers, and assists/directs TPA adjusters to resolve claims according to US Best Practices.

The Sr. TPA Specialist regularly communicates with TPAs, customers, brokers, Business Unit Underwriters and representatives, TPA Operations, Claims Legal, Corporate Law, and Senior Management to facilitate and ensure the resolution of a variety of high exposure liability claims including Trucking, Auto, UM/UIM, PIP, Employers Liability, Excess claims, Premises, and Product Liability claims.

The ideal candidate will have a strong background in complex coverage analysis, prior experience in a managerial role, and prior experience in handling trucking claims. Also important is demonstrated organizational and time management skills, proven diary management skills and must be able to document claim files by accurately capturing and updating claims data/information in compliance with best practices. They must also be able to establish timely and accurate reserves and perform ongoing reassessments throughout the claims cycle while providing guidance and leadership to the TPA adjusters.

Basic Qualifications:

• Bachelors Degree and 8 or more years of experience in the Claims Technical area
  OR
• Juris Doctor and 4 or more years of experience in the Claims and Litigation Management area.
  OR
• High School Diploma or Equivalent and 10 or more years of experience in the Claims and/or Litigation Management area
  OR
• Zurich Certified Insurance Apprentice, including an Associate Degree with 8 or more years of experience in the Claims and/or Litigation Management area
  AND
• Must obtain and retain required adjuster licenses
• Microsoft Office experience
• Knowledge of insurance regulations, markets, products and coverage
  
  Preferred Qualifications:

• AIC, SCLA or CPCU
• Effective verbal and written communication skills
• Strong analytical, critical thinking and problem-solving skills
• Self-starter with ability to oversee work and projects from start to finish with minimal supervision
• Able to work on multiple projects simultaneously in a fast-paced environment
• Experience collaborating in a team environment and building cross functional working relationships
• Able to present information effectively and succinctly to senior leaders, BU and customers
• Able to direct and control legal actions and expenses, negotiations, and trial strategy on large complex auto and casualty claims in accordance with Zurich Best Practices
• Ability to direct defense counsel on an ongoing basis to guide the course of complex litigation and settlement strategies
• Able to analyze coverage issues and interaction between laws of various states, recommend and implement strategies
• Experience with coverage issues involving analyzing jurisdictional and service of process issues for lawsuits
• Demonstrated understanding of additional insured and contractual indemnity issues.
• Ability to analyze and effectively communicate complex coverage determinations to customers/clients/brokers for catastrophic claims
• Able to explain deductible billing and reinsurance on GL insurance programs and able to explain the difference between SIRs and deductibles
• Proven ability in coordination of coverage disputes and claims handling with co-defendants and other carriers
• Ability to determine the scope and exposure for complex claims.
• Ability to follow reserving process for indemnity and expense in analyzing the exposure of a broad variety of complex claims
• Able to provide guidance and grant authority on moderate to large exposure GL claims
• Able to interface wit