SR Claims Specialist

1 month ago

Lakewood, United States Ultimate Staffing Full time

Must reside in Denver Metro Area. Hybrid Schedule: 3 days onsite - 2 days WFH

Location: Lakewood CO 80215

Compensations: $70k-$100K Annual Salary DOE

*** Must have Litigation & Construction Defect experience

Position Summary:

This position provides essential support in managing claims across various coverage lines, focusing on Liability (Commercial Auto and General Liability). Responsibilities include assessing claim coverage, liability, legal and damage issues, and investigating, evaluating, and resolving assigned claims efficiently according to regulatory guidelines. This role also ensures a high level of customer service for both internal and external stakeholders.

Primary Responsibilities:

  • Policy Review and Interpretation: Analyze and interpret policy conditions, exclusions, and endorsements to address coverage and liability issues for assigned claims.
  • Claims Documentation: Prepare reservation of rights letters, nonwaiver agreements, and coverage disclaimers as needed.
  • Reserve Evaluations: Review claim reserves to ensure they accurately reflect potential exposure.
  • Claims Investigation: Conduct thorough investigations to assess coverage and legal issues; this may involve meeting with insured parties, witnesses, and collecting statements and evidence.
  • Record Maintenance: Document and report on all investigation and claims handling activities comprehensively.
  • Claims Negotiation and Settlement: Negotiate settlements through mediation, arbitration, or court-supervised efforts, and resolve claims with claimants, insureds, and legal representatives, providing appropriate claims resolution documentation.
  • Regulatory Knowledge: Maintain current knowledge of regulatory and jurisdictional requirements.
  • External Collaboration: Manage and direct defense counsel, independent adjusters, and other third parties assisting with claims.
  • Additional Responsibilities: Carry out other duties as assigned.

Qualifications:

  • Experience: Minimum of 5 years in:
    • Coverage Review: Interpreting policies, agreements, and preparing reservation of rights and disclaimers.
    • Claims Investigation: Taking statements, managing authorizations, and retaining experts and counsel as necessary.
    • Claims Administration: Reporting, reviewing reserves, and complying with applicable laws and procedures.
    • Claims Settlement: Preparing disclaimers, releases, and proof of loss statements, and participating in legal proceedings when needed.
  • Knowledge Requirements: Strong understanding of coverage, negligence principles, investigation, and negotiation techniques.
  • Licensing: Ability to obtain and maintain state adjusting licenses as required.
  • Customer Service: Service-oriented with a commitment to efficient and effective claims and customer service.
  • Communication Skills: Excellent communication skills for interaction with customers, claimants, counsel, and the public.
  • Organization: Ability to manage multiple tasks and prioritize workload.
  • Decision-Making: Strong judgment, negotiation, and decision-making skills.
  • Travel Requirements: Must be able to travel efficiently to various off-site locations, including potential overnight stays.
  • Geographic Experience: Experience handling liability claims in western states, including but not limited to Montana, Wyoming, Colorado, New Mexico, Idaho, Utah, Arizona, California, Washington, and Oregon.

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance. For unincorporated Los Angeles county, to the extent our customers require a background check for certain positions, the Company faces a significant risk to its business operations and business reputation unless a review of criminal history is conducted for those specific job positions.

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