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Seeking claims professional with experience in liability claims and coverage. Commercial general liability background required. CG 00 01 experience required. Strong written and verbal communication required. Position is open to anywhere in the United States and is a work from home opportunity.
Primarily responsible for investigating, evaluating and resolving commercial, and professional lines claims and lawsuits of a more severe and complex nature, or from a specialty line or program of significant value to the organization.. File inventory typically includes litigation, complex coverage issues. Works with claims divisional managers and directors to develop training plans and strategies for the claims division. Responsible for coaching, training and mentoring of individual team members. Acts as a subject matter expert in a particular line of business or risk. Works with General Agents, and internal business partners to maintain, develop and influence relationships with major customers or key individuals.
Reporting Relationships: Reports to Sr. Claim Manager, Director.
Core Duties and Responsibilities:
* Investigates, evaluates, and resolves claims and lawsuits of a more severe and complex nature, or from a specialty line or program of significant value to the organization. Acts as a subject matter expert in a particular line of business or risk.
* Identifies technical training needs and develops action plans to meet those needs as required. May provide technical consultation/direction to all levels of claim professionals. Functions as a content expert to assist in developing training curricula.
* Responsible for developing and maintaining open and trusting working relationships with general agents, producers, and key internal business partners.
* Responsible for timely and appropriate evaluation of claims to identify and manage reserves in compliance with Company standards and reserving best practices.
* Maintains current knowledge of: multiple coverage lines; venue specific court decisions which may impact the claims function; current guidelines in the claims function; and policy changes and modifications. This may require attendance at various seminars and training sessions.
* Reviews and analyzes files to ensure adherence to Division guidelines and claims handling best practices. Reviews claims quality results to identify coverage trends and to ensure consistency in policy interpretation. Recommends training or other appropriate action.
* May provide technical consultation/direction to complex claims which require the highest level of technical skill and expertise.
* Provides specialized consultation to ensure proper attorney assignments, proper reserving, prompt and accurate reporting to reinsurance carriers, prompt and fair negotiations, and adequate preparation for trial, if necessary.
* Monitors litigation trends and handling practices to ensure that lawsuits are handled in a consistent fashion. Maintains trial log for each line of business in different channels.
* May designs specific Reservation Of Rights templates for use by technical associates across channels. Approves all Reservation Of Rights, disclaimers, tender/rejection/acceptance letters.
* May assist in new product development and management. Provides claims handling expertise to new product development. Provides standardized processes for claims handling related to new products.
* Performs other related duties as assigned.
Typical Skills and Experiences:
Education: Undergraduate education in insurance, business, management, or related fields. Advanced degree preferred. Additional education in a particular line of business may be required by the hiring business unit.
Licenses/Registrations/Designations: Associates must obtain the required Federal and/or state licenses/registrations within the time period designated by the business unit. Additional licenses/registrations may be required when new products and services are implemented. If an associate fails or is unable to obtain required licenses/registrations within the time period designated by the business unit, the associate will be ineligible to continue in the position.
Completion of insurance courses such as IIA, AEI, or CPCU preferred.
Experience: 8 or more years prior insurance experience preferred. Proven experience handling and/or managing higher severity and/or complex claims and litigation required. Proven experience analyzing and handling complex coverage issues. Specific experience in a particular line of business may be required by the hiring business unit.
Knowledge, Abilities, and Skills: Proven knowledge of the best claims practices used to resolve severe claims practices used to resolve severe claims. Proven knowledge in a particular line of business and/or additional education may be required by the business unit. Proven analytical skills to make independent decisions and resolve conflict in such areas as application of coverage to submitted claims, application of laws of jurisdiction to investigation facts, application of policy exclusions and exceptions Much be able to effectively communicate and interact with other claim professionals in a leadership capacity. This includes the ability to maintain open and trusting working relationships while teaching, coaching and mentoring other claim professionals in a compassionate and empathetic manner. Ability to develop and maintain open and trusting working relationships with insureds in order to gather pertinent information. Has the ability to effectively manage conflict and practices attentive and active listening. Ability to work independently and deal with ambiguity.Ability to present to all levels of management .
Overtime Eligibility: Not Eligible (exempt)
Working Conditions: Normal office environment. Travel as necessary.
ADA: The above statements cover what are generally believed to be principal and essential functions of this job. Specific circumstances may allow or require some people assigned to the job to perform a somewhat different combination of duties.
Credit Check: Due to the fiduciary accountabilities within this job, a valid credit check and/or background check will be required as part of the selection process.
Additional Job Description
Associated topics: automobile, bodily, claim, claim examiner, claimant, fraud, insurance examiner, insurance investigator, investigation, liability