Technical Claims Specialist

1 month ago


Houston, United States General Search & Recruitment Full time
Job DescriptionJob DescriptionTechnical Claims Specialist
Houston, TX

A well-respected Insurance Carrier is seeking a qualified and experienced Technical Claims Specialist to join our dynamic team.

As a Technical Claims Specialist, you will play a crucial role in managing and resolving a variety of commercial claims, including general liability, property, Inland Marine, automobile bodily injury, property damage, and potentially worker's compensation claims.

If you have a strong background in claims handling, exceptional communication skills, and a commitment to delivering excellent service, we invite you to apply for this exciting opportunity.

Key Responsibilities:
  • Handle, negotiate, and resolve first and third-party commercial claims, ensuring compliance with company policies and state regulations.
  • Conduct thorough investigations, maintaining constant communication with customers and relevant internal and external stakeholders.
  • Document all key activities, contacts, and statements, including comprehensive outlines of claim requirements.
  • Demonstrate proficiency in medical terminology, treatment, and injury descriptions.
  • Recognize and assess potential damage related to injuries.
  • Manage the claim authorization process and complete loss investigations using appropriate techniques.
  • Evaluate compensability and exposure, identifying subrogation opportunities and suspicious claims.
  • Prepare accurate and timely reports and state filings as required.
  • Establish and maintain accurate reserves, adhering to state regulatory compliance requirements.
  • Verify, analyze, and apply coverage correctly.
  • Develop negotiation strategies for claims resolution, considering state compliance and company policies.
  • Create resolution plans based on a thorough analysis of facts, defenses, compensability, and statutory/case law.
  • Keep policyholders, underwriting, and agents informed of file status and other relevant matters.
  • Participate in presentations, meetings, or visits related to claims resolution, service, or technical issues.
  • Stay updated with relevant continuing education requirements.
Candidate Qualifications Sought:
  • Minimum of 7 years of multi-line claims experience.
  • Current Texas claims adjuster license required; additional licenses are a plus.
  • Preferred experience in handling claims across multiple jurisdictions.
  • Familiarity with Contractual Risk Transfer concepts and anti-indemnity laws.
  • Strong attention to detail and accuracy in documentation and data management.
  • Excellent written and verbal communication skills, with a strong ability to listen effectively.
  • Adept at resolving differences in opinions and misunderstandings through open discussion.
  • Demonstrates accountability for actions and holds self and others responsible to organizational standards.
  • Exceptional organizational skills and the ability to prioritize work effectively.
Join our client’s team and make a significant impact in the field of claims management. If you meet the qualifications and are ready to take on this challenging and rewarding role, we encourage you to apply today.


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