Sr. Claims Specialist, Professional Liability (Cyber)

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Sr. Claims Specialist, Professional Liability (Cyber)

PRIMARY PURPOSE: To analyze complex or technically difficult Cyber and other Professional Liability claims; to provide resolution of medium to highly complex nature claims; to perform within Company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

Claims Management and Processing:

• Handle a diverse portfolio of cyber claims, including various Professional Liability claims, for various insurance company clients
• Conduct comprehensive investigations into incidents, including data breaches, ransomware attacks, and business interruption claims
• Analyze policy wordings and determine coverage applicability for each claim
• Draft coverage letter
• Maintain accurate claim files and documentation in compliance with client-specific guidelines and regulatory requirements
• Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost.

Client Relations:

• Serve as the primary point of contact for assigned insurance company clients
• Provide regular updates and reports to clients on claim status, trends, and potential high-exposure cases
• Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement.
• Represents Company in depositions, mediations, and trial monitoring as needed.

Vendor Management:

• Coordinate with and oversee external vendors, including forensic experts and legal counsel
• Manage vendor expenses and ensure adherence to client-specific billing guidelines
• Evaluate vendor performance and make recommendations for the vendor panel

Technical Expertise:

• Stay current with evolving cyber threats, industry trends, and best practices in cybersecurity
• Provide technical guidance to less experienced team members on complex cyber claims

Reporting and Analytics:

• Prepare detailed claim reports and analyses for insurance company
• Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life.
• Refers cases as appropriate to supervisor and management.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.
• Supports the organization's quality program(s).

QUALIFICATIONS

Education & Licensing
Bachelor's degree from an accredited college or university required. JD preferred. Adjuster Licenses as required. Professional certification as applicable to line of business preferred.

Experience
At least five (5) years of claims management experience, with at least (2) years of cyber claims management experience, or equivalent combination of education and experience required.

Skills & Knowledge

• In-depth knowledge of appropriate Cyber and other Professional Liability lines, including E&O, D&O, EPL, etc. insurance principles and laws for line-of-business handled, cost containment principles and procedures as applicable to line-of-business
• Excellent oral and written communication, including presentation skills
• PC literate, including Microsoft Office products
• Analytical and interpretive skills
• Strong organizational skills
• Excellent negotiation skills
• Good interpersonal skills
• Ability to work in a team environment
• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT