The Claims Specialist investigates, evaluates, negotiates, and resolves litigated and non-litigated property damage, personal and advertising injury, and claims of medium exposure and complexity. This individual will work under limited supervision, with a remote manager.
Key Functions:
- Analyze coverage, identify coverage issues, and prepare coverage letters for supervisor approval
- Investigate and evaluate liability
- Investigate and evaluate damages
- Manage litigation by assigning counsel from the approved panel where applicable, establish litigation plan and budget, coordinate with defense counsel, and continuously review the potential for resolution.
- Establish timely reserves within authority and re-evaluate throughout the life of the claim
- Maintain up-to-date, appropriate file documentation and written file notes
- Maintain an active diary and productive file inventory
- Timely completion of all required large loss reporting
- Negotiate settlements within authority limit granted, and attend mediations, mandatory settlement conferences, and/or alternative dispute resolutions
- Proactively control the work product and expense of outside vendors
- Develop and maintain positive customer relationships and provide superior customer service
- Timely identify all potential opportunities for co-insurance, transfer of risk and/or subrogation
- Ability to Work with designated assigned accounts
- Recognize and investigate fraud
- Comply with deductible/self-insured retention recovery protocol
- Meet and maintain all state licensing requirements at all times (see qualifications below)
- Adhere to all statutory regulations, unfair claims practices acts, and corporate best practices
- All other duties as assigned