Senior Claims Specialist (Open to remote)

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This position will be responsible for the resolution of moderate to high complexity and moderate to high exposure claims which can be subject to disputes that must be resolved in mediation or litigation. The primary purpose of this job is to handle claims from coverage enquiry through legal liability assessment (where relevant) and quantum analysis, to timely and accurate resolution; ensuring mitigation of indemnity and expense exposure while communicating developments and outcomes as necessary to all internal and external stakeholders. The position will have increased responsibility for decision making within their authority and work with minimal oversight and will provide training and be a technical referral point for other team members.

• Analyzes coverage and communicates coverage positions
• Conducts, coordinates, and directs investigation into loss facts and extent of damages
• Confirms coverage of claims by reviewing policies and documents submitted in support of claims
• Contributes to maintenance of claims guidelines and best practice procedures
• Coordinates loss information for business stakeholders and presents information during meetings with underwriters and/or insureds when applicable
• Delivers technical training to colleagues and external contacts as appropriate
• Directs and monitors assignments to experts and outside counsel, ensures effective vendor and litigation management on moderate to high complexity claims including demonstrable savings
• Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure
• Negotiates and settles claims typically in litigation either directly or indirectly
• Participates in special projects or assists other team members as requested
• Prepare coverage position letters on matters typically in litigation without assistance of outside coverage counsel.
• Prepares reports by collecting and summarizing information
• Present at roundtables to senior claims leaders and underwriters on cases going to trial
• Provides timely service throughout the life cycle of the claim by meeting all service level agreements, initiating timely contact to all appropriate parties, and responding to incoming inquiries according to company policy and procedures.
• Sets reserves within authority or makes claim recommendations concerning reserve changes to manager
• Travel to mediations, trials, and conferences as required
• Utilizes acceptable investigation claims handling and settlement techniques that achieve cost effective and timely closure results by obtaining, reviewing and analyzing documentation, policy provisions and other records.

Education

• Bachelor’s degree or equivalent work experience
• JD , advanced degree, or focused technical degree a plus

Certification

• Must have or be eligible to receive claims adjuster license.
• Successful achievement of industry designations (INS, IEA, AIC, ARM, SCLA, CPCU) or
• Participation in industry training opportunities (CLM Claim College, Munich Re Training, FDCC, etc.)

Work Experience

• Minimum of 7-15 years of claims handling experience or equivalent combination of education and experience in insurance
• Successful completion of 5 years as a Claims Examiner

Skill Sets

• Excellent written and oral communication skills
• Strong analytical and problem solving skills
• Strong organization and time management skills
• Experience in negotiation, mediations, arbitrations and monitoring trials on higher value complex claims
• Ability to influence claims team members and to effectively direct claims strategy
• Strong vendor leadership skills are required including the ability to provide direction and guidance to defense attorneys, independent adjusters, building consultants, forensic accountants and other experts while controlling expenses.
• Ability to assist with technical training to team claim handlers as required
• Well developed and advanced expertise and knowledge in most technically complex claims topics
• Policy language skills enabling accurate and consistent policy wording interpretation
• Experience in effectively following up on recommendations from technical claims audits and continuous file handl