Description
- Investigate and settle advanced, large loss, complex claims promptly and equitably under minimal supervision.
- Works within established authority on moderate-to-difficult claims.
- Reviews coverages, determines liability and compensability, secures information, arranges property damage appraisals and settles claims utilizing claims best practices.
- Evaluates and sets reserves using independent judgment.
- Assists supervisor and company attorneys in preparing cases for litigations.
- Conducts training and mentors new hires.
Responsibilities
- Interprets and makes decisions using independent judgment on more complex and unusual policy coverages and determines if coverages apply to claims submitted.
- Manages all aspects of investigative activity on complex claims.
- Directs the discovery and litigation strategy with legal counsel.
- Analyzes claims activity and prepares reports for clients/carriers and management.
- Establish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost effective manner and ensuring timely issuance of disbursements.
- Settles claims promptly and equitably and issues company drafts in payments for claims within authority limits.
- Develops subrogation and third party recovery potential and follows reclaim procedures.
- Analyzes claims activities and prepares reports for clients, carriers and/or management.
- Participates in claim reviews.
Qualifications
- Bachelor's degree or equivalent experience required.
- Industry designations preferred but not required (IIA, AIC, AEI and/or CPCU).
- Technical claims investigations/settling experience with 4-8 years experience in Claims or similar organization.
- Ability to work independently while assimilating various technical subjects.
- Strong written and oral communication, negotiation and presentation skills.
- Advanced analytical and problem solving skills, with the ability to manage and prioritize multiple projects.
- Effective advanced interpersonal skills to effectively interact with all levels of internal and external clients.
- Workers Compensation (WC) Adjuster License required according to jurisdictional requirements
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