About the position

Investigates, evaluates and resolves Liability claims in assigned geographical jurisdictions, while interacting daily with internal and external stakeholders in order to thoroughly and fairly resolve claims.

Responsibilities

• Handles claims in assigned territories from start to finish, including thorough liability investigations and resolutions based on sound claims adjusting best practices and company guidelines.
• Oversees the activities of contracted vendors when utilized.
• Interacts with field employees and customer service functions, answering questions, explaining liability and other technical issues, while informing Claims hierarchy of all claim-related circumstances (i.e.: customer complaints, regulatory/executive complaints, etc.) requiring Management intervention/response.
• Ensures completion of thorough internal claim-status communications to management/leadership and other departments as appropriate.
• Ensure thorough claim-status communications when appropriate to Legal, Risk Management, excess insurance broker/carriers, etc., including timely issuance of reports when appropriate.
• Follows protocols in establishing reserves/receivables and securing settlement authority per guidelines.
• Ensures all claims are properly documented and assertively handled.
• Ensure all claims are properly reserved for anticipated liabilities or recoveries, reviewing reserve adequacy at least once per month, and properly requesting authority to adjust large reserves.
• Ensures that all claims are properly coded in the claims database with respect to workgroup, cause of incident, charging of payments/recoveries, etc.
• Ensure thorough running notes and formal reporting is maintained in all claim files per requirements.
• Identifies opportunities for process improvements and spend/cost reductions, often participating on related teams.
• Participates in Safety training/reporting programs, storm response teams and in acts of volunteerism.

Requirements

• Bachelor’s degree, generally in Liberal Arts, Business, Insurance or Health Administration.
• Customer Service Spec I: 3-5 years of liability claims adjusting experience with property & casualty insurer, third-party administrator or self-insured employer group.
• Customer Service Spec II: 5+ years of liability claims adjusting experience with property & casualty insurer, third-party administrator or self-insured employer group.
• Customer Service Spec Sr: 10+ years of liability and/or subrogation claims adjusting experience with property & casualty insurer, third-party administrator or self-insured employer group.
• Commitment to Safety.
• Ability to explain the processes of investigating, evaluating, negotiating, resolving, documenting and reporting-on complex claims.
• Understanding elements of compensability, legal liability, fact-finding/discovery and methods for claim adjudication.
• Ability to communicate with all levels throughout an organization, resolve conflict, accept push-back and criticism, understand “economic” decision-making, prioritize work, operate standard computer applications, successfully answer required behavior-based questions.
• Understanding elements of legal liability, fact-finding/discovery and methods for claim resolution/adjudication.
• Acts as a resource for colleagues with less experience; may lead projects with manageable risks and resource requirements.
• Solves complex problems; takes a new perspective on existing solutions; exercises judgment based on the analysis of multiple sources of information.
• Impacts a range of customers, operational, project or service activities within own team and other related teams; works within broad guidelines and policies.
• Ability to explain difficult or sensitive information; works to build consensus.
• Ability to prioritize and organize work.
• Ability to work independently in a fast-paced environment with diverse internal/external stakeholders
• Ability to operate computer applications, such as Word, Excel, PowerPoint and claims database.
• Licensed Claims Adjuster (may be secured within the first year of employment).

Nice-to-haves

• Master’s degree a plus.
• Industry claims designation (SCLA, CWCP, AIC, etc.).