Sr. Complex Claims Specialist

1 month ago

Atlanta, Georgia, United States The Ladders Full time
Job Type:
Permanent
Build a brilliant future with Hiscox
Hiscox USA underwrites small- to mid-market commercial risks through brokers, other insurers and distribution partners and directly to businesses. In 2023, gross written premiums for the segment will represent over $1bn. Approximately 50% of the portfolio comprises small commercial business sold either online or through intermediaries, and the remaining 50% represents traditionally traded business intermediated through broking partners for Property and Casualty and Specialty Lines, including Professional Liability, Cyber, Technology and Media & Entertainment. Hiscox USA has built the digital business through ongoing investment in the brand, technology and operational capabilities. The business has pursued an omni-channel approach from its inception and is less constrained by the channel conflict that affects some competitors. Customers have a choice of buying policies online end-to-end, by connecting with a Hiscox agent over the telephone, or alternatively through a third-party broker or insurance carrier partner. The business follows an 'all roads lead to Hiscox' philosophy, ensuring it is available to do business with target customers whichever way they choose.
The team:
The Hiscox US Claims team is a dynamic and growing group of technically minded professionals working together to provide superior customer service, through exemplary claims handling leading to positive claim outcomes. The Claims staff is empowered to manage their claims within given authority to provide fair and fast resolution of claims for our policy holder and broker partners. With strong growth across the US business, the Claims team is focused on delivering first in class claims service while reinforcing Hiscox's strong brand built on a long history of outstanding claims handling.
The role:
The Senior Complex Claims Specialist is the most senior technical role on the team. This person will be responsible for adjudicating assigned claims within their given authority and providing operational support to the claims team. This person:
  • With minimal supervision, adjusts to resolution the highest severity claims and drafts the most complex technical coverage analysis and letters required in the given claim department
  • Will act as a media liability subject matter expert and adjust media liability claims. Will also handle cyber, tech E&O and crime claims to a lesser degree
  • Responsible for implementing and executing Hiscox's Best Practices, including but no limited to reserve-setting and reserve timeliness, undertaking comprehensive coverage analysis, developing claim-handling strategy, in an effort to align with and deliver Hiscox's KPIs, execute on strategies to efficiently manage claims and claim outcomes and deliver excellent service
  • Follows litigation best practices and strategy, including attending and leading trials and mediations
  • Uses superior knowledge and experience to affect positive claim outcome via investigation, negotiation and utilization of alternative dispute resolutions
  • Identifies and provides potential solutions for emerging exposures and claims trends
  • Identifies suspected fraudulent claims and tracks with special investigations unit
  • Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities
  • Mentors other team members
  • Reviews and analyzes claim documentation and legal filings and recommends an appropriate response
Required skills and experience
  • At least 10 years of experience in handling claims. A JD from a law school with ABA accreditation may count as additional claims handling experience
  • 5
    years of experience in Media claims; experience handling Cyber, Tech E&O and Commercial Crime claims is also a plus.
  • Expert knowledge of claims handling practices, including coverage analysis, litigation management and negotiation
  • Excellent analytical, critical thinking and communication skills are a must
  • Strong skills in building engagement, rapport and relationships with others
  • Advanced analytical skills for evaluating coverage and for developing and executing claim-handling strategies to achieve optimal claim results
  • Evidence of efforts to enhance product innovation, improve claims processes and/or gain a deeper understanding of other aspects of the business through training, interactions with external/internal stakeholders or other relevant projects
  • Dedication to excellent customer service
  • Insurance adjuster license(s), or willingness to obtain them
What we offer
  • 401(k) with competitive company matching
  • Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care)
  • Company paid group term life, short- term disability and long-term disability coverage
  • 24 Paid time off days plus 2 Hiscox days,10 paid holidays plus 1 paid floating holiday, and ability to purchase up to 5 PTO days
  • Paid parental leave
  • 4-week paid sabbatical after every 5 years of service
  • Financial Adoption Assistance and Medical Travel Reimbursement Programs
  • Annual reimbursement up to $600 for health club membership or fees associated with any fitness program
  • Company paid subscription to Headspace to support employees' mental health and wellbeing
  • 2023 Gold level recipient of Cigna's Healthy Workforce Designation for having a best-in-class health and wellness program
  • Dynamic, creative and values-driven culture
  • Modern and open office spaces, complimentary drinks
  • Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation
Please note that this position is hybrid and requires 2 days in office weekly. The position can be based in one of the following locations:
White Plains, NY
Manhattan, NY
Chicago, IL
Atlanta, GA
West Hartford, CT
Salary range: $150k-$175k
#LI-AJ1
Work with amazing people and be part of a unique culture
Estimated Salary: $20 to $28 per hour based on qualifications.

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