Complex Claims Representative

11 hours ago

Wyomissing Berks County United States CNA Insurance Full time

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.

CNA is the market leader in providing Accountants Professional Liability coverage and provides best-in-class claim service. We are seeking a dynamic self-starter to join our team as a Complex Claims Representative handling claims for accounting firms nationwide. The Complex Claims Representative plays a critical role in managing and resolving complex accounting malpractice claims by evaluating coverage, assessing liability and damages, setting timely reserves, negotiating and settling claims, and directing litigation. The Complex Claims Representative will collaborate in a rich team environment including claim leadership and business partners to ensure the best possible outcome on every claim.

JOB DESCRIPTION:

Performs a combination of duties in accordance with departmental guidelines:

  • Manages an inventory of low to moderate complexity and exposure commercial claims by following company protocols to verify policy coverage, gather necessary information, maintain appropriate file documentation and authorize disbursements within authority limit.
  • Contributes to customer satisfaction by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information.
  • Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language, estimating potential claim valuation, and following company's claim handling protocols.
  • Exercises judgement to determine liability and compensability by conducting investigations to gather pertinent information, taking recorded statements from insureds, witnesses and working with experts to verify the facts of the claim.
  • Works with appropriate internal and external partners, suppliers and experts by identifying and effectively collaborating with necessary resources to facilitate best claim outcomes.
  • Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate.
  • Developing ability to manage expenses by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service.
  • Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Claim, Recovery or SIU resources for further investigation.
  • Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements.
  • Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business.

May perform additional duties as assigned.

Reporting Relationship

Typically Manager or above

Skills, Knowledge & Abilities

  • Developing basic knowledge of the commercial insurance industry, products and claim practices.
  • Good verbal and written communication skills with the ability to demonstrate empathy while providing exceptional customer service.
  • Ability to develop collaborative business relationships with both internal and external work partners.
  • Able to exercise independent judgement, solve basic problems and make sound business decisions.
  • Analytical mindset with critical thinking skills.
  • Strong work ethic, with demonstrated time management and organizational skills.
  • Ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity.
  • Knowledge of Microsoft Office Suite and ability to learn business-related software.
  • Adaptable to a changing environment
  • Ability to value diverse opinions and ideas

Education & Experience:

  • Bachelor's Degree or equivalent experience. JD or tax/accounting experience preferred.
  • Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.
  • Prior claim handling, or business experience in the insurance industry and/or customer service is preferred.
  • Candidates who have successfully completed the CNA Claim Training Program may be considered after 1 year of claim handling experience.
  • Professional designations are a plus (e.g. CPCU)
#J-18808-Ljbffr

  • Complex Claims Specialist

    11 hours ago

    Dallas, TX, United States PuroClean Certified Restoration Specialist of Auburn Full time

    Our client is a leading international carrier in search of a Complex Claims Specialist to join their Professional Liability Division. This role can be housed nationwide in any hub office (or remote with occasional travel into the office) including Chicago, New York, Atlanta, Dallas, or Scottsdale. This individual will function as a high level adjuster,...

  • Claims Representative, APD

    5 months ago

    Wyomissing, United States CNA Full time

    JOB DESCRIPTION : Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of low to moderate complexity and exposure commercial claims by following company protocols to verify policy coverage, gather necessary information, maintain appropriate file documentation and...

  • Accounting and Claims Managing Director

    11 hours ago

    Edina, MN, United States Howden Group Holdings Full time

    Howden Re is the global reinsurance broker and risk, capital & strategic advisor focused on relentless innovation & superior analytics for top client service. About Role Howden Re is the global reinsurance broker and risk, capital, & strategic advisor focused on relentless innovation & superior analytics for top client service. We are looking for a Managing...

  • Complex Claims Admin

    4 weeks ago

    Chicago, IL, United States Harris & Harris Full time

    Harris & Harris has over 50 years of experience in the customer service and revenue recovery field, specializing in the utilities, government, and healthcare markets. We’re looking for friendly, professional, and motivated Complex Claims Administrator join our Legal Compliance team. If you’re looking for a company that embraces the principles of respect,...

  • Workers Compensation Claims Consultant

    6 months ago

    Wyomissing, United States CNA Full time

    JOB DESCRIPTION : Essential Duties & Responsibilities Performs a combination of duties in accordance with departmental guidelines: Manages highly complex investigations of claims, including coverage issues, liability, compensability and damages. Determines if a major claim should be settled or litigated and implements an appropriate resolution strategy...

  • Bodily Injury Pro Se Claims Adjuster

    4 weeks ago

    Roanoke, TX, United States ICM Claims Full time

    At ICM Claims, we look for the best and brightest talent to join our team of professionals. We're united by a common purpose of delivering exceptional claim handling.Reasons you should consider a career with ICM Claims:Culture: Our Core Values are embedded into our culture of how we treat our employees as a valued partner-with integrity, passion and...

  • Billing Claims Representative

    11 hours ago

    San Francisco, CA, United States University of California San Francisco Full time

    The Billing/Claims Unit is responsible for billing hard copy claims, working in the Claims Edit Work queues, and following up on return mail. The unit deals regularly with complex policy and procedural issues that involve contract compliance with HMO and PPO payers. It is the unit's responsibility to communicate and coordinate throughout various UCSF Medical...

  • Auto Liability Exp. Claim Rep.

    5 months ago

    Wyomissing, United States Travelers Full time

    Who Are We? Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine...

  • Complex Claims Director

    11 hours ago

    Atlanta, GA, United States American International Group Full time

    Complex Claims Director - Retail Complex Claims Director – Retail Join us as a Complex Claims Director to grow your experience in Claims. Make your mark in Claims Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global...

  • Claims Complex Director TPA

    11 hours ago

    Atlanta, GA, United States American International Group Full time

    Claims Complex Director TPA Complex Claims Director TPA Join us as a Complex Claims Director, Third Party Administrator (TPA) to grow your experience in Claims. Make your mark in Claims Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an...

  • Commercial Claims Representative

    4 weeks ago

    Des Moines, IA, United States Farm Bureau Financial Services Full time

    Commercial Claims Representative Do you have past commercial claims experience and a strong customer service mindset? Are you a go-getter with high initiative and a positive attitude? Do you thrive in a work environment where you must multi-task and have strong organizational skills? If so, this Commercial Claims Representative opportunity could be a great...

  • Senior Claims Representative

    4 weeks ago

    Rocky Hill, CT, United States Kelly Recruiting Full time

    Job Description:We are seeking a Senior Claims Representative to handle a caseload of claims and support the operations of the Claims Department and company. The primary responsibilities of the position are to investigate, evaluate and resolve medical professional liability claims brought against the company’s insureds. The position requires handling...

  • Senior Claims Representative, Liability

    2 weeks ago

    Boston, MA, United States Plymouth Rock Assurance Full time

    Overview: Is this your next job Read the full description below to find out, and do not hesitate to make an application. If you are a seasoned claims professional with a passion for delivering exceptional results and have a proven track record in homeowner liability claims, we invite you to apply and join our dynamic team at Plymouth Rock Home Assurance....

  • Auto Liability Claim Rep Trainee

    6 days ago

    West Wyomissing, Pennsylvania, United States VetJobs Full time

    Compensation OverviewThe annual base salary range for this position is $42,100.00 - $69,500.00, depending on factors such as location and experience.About the RoleThis Auto Liability Claim Rep Trainee role is a formal training program designed to advance employees to an Auto claim representative position. The successful candidate will develop skills in...

  • Billing Claims Representative

    11 hours ago

    San Francisco, CA, United States University of California - San Francisco Campus and Health Full time

    Billing Claims Representative Medical Group Business Services Full Time 82351BR Job Summary The Billing/Claims Unit is responsible for billing hard copy claims working in the Claims Edit Work queues and following up on return mail. The unit deals regularly with complex policy and procedural issues that involve contract compliance with HMO and PPO payers. It...

  • Auto Property Claims Adjuster

    3 weeks ago

    Boston, MA, United States CyberCoders Full time

    Position Overview: The Auto Property Claims Adjuster - Complex PD is responsible for the timely and accurate assessment and settlement of auto property claims for complex damage. This position requires someone with strong problem-solving and negotiation skills, as well as the ability to accurately interpret policy coverages.Key ResponsibilitiesConduct...

  • Auto Property Claims Adjuster

    4 weeks ago

    Boston, MA, United States CyberCoders Full time

    Position Overview: The Auto Property Claims Adjuster - Complex PD is responsible for the timely and accurate assessment and settlement of auto property claims for complex damage. This position requires someone with strong problem-solving and negotiation skills, as well as the ability to accurately interpret policy coverages.Key ResponsibilitiesConduct...

  • Complex Claims Consultant

    11 hours ago

    Village of Tarrytown, NY, United States CNA Insurance Full time

    You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. CNA is the market leader in providing Lawyers liability coverage and...

  • Complex Claims Specialist

    11 hours ago

    Village of Tarrytown, NY, United States CNA Insurance Full time

    You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. CNA is the market leader in providing Lawyers liability coverage and...

  • Claims Service Representative

    2 weeks ago

    Des Moines, IA, United States Farm Bureau Financial Services Full time

    Claims Service Representative**Will be filled at the appropriate level based on experience**Do you thrive in a work environment where you must multi-task and have strong organization skills? Are you a go-getter with high initiative and a positive attitude? Do you have strong customer service and time management skills? If so, this Claims Service...