Insurance Claims Coverage Specialist

2 weeks ago

Wayne, United States USLI Full time

Essential functions include: Identify, evaluate, and analyze coverage issues as well as applicable coverages. Draft comprehensive coverage and denial letters. Provide oversight of outside coverage counsel, including the supervision of coverage litigation. Serve as claims counsel. Proactively negotiate settlement of claims within evaluation and designated authority level. Process and pay claims and expense invoices in a timely manner and within designated authority level. Perform legal research and provide legal coverage opinions to claims personnel on all product lines involving coverage issues. Keep abreast of insurance coverage case law, trends and experience and prepare summaries for dissemination of information within the company on coverage cases and trends. Develop and present training programs to internal claims departments and participate in roundtable conferences with claims personnel on legal coverage matters. Assist in drafting policy language, working closely with underwriting and corporate legal. Travel as necessary to attend arbitrations, mediations, settlement conferences or trials. Participate in customer service visits or to further customer service relations. Perform other duties as assigned.

**Other Duties and Responsibilities**:

- Special Projects: Complete special projects assigned by leadership.
- Continuing Education**: Attend educational seminars and conferences. Enroll and complete continuing education programs for both professional and personal development as outlined in annual Training and Development Plan.

**Minimum Job Requirements**:
**Education**:Juris Doctorate.

**Experience**: 3 to 7 years of claims handling experience with strong coverage background, claims counsel experience and/or relevant legal and/or litigation experience (lawyer, attorney).

**Specific Skills**:
Strong oral and written communication skills

Strong analytical skills

Strong negotiation skills

Strong organizational skills

Ability to work independently in a fast-paced environment

**Specialized Knowledge, Licenses, etc.**: JD. Good working knowledge of Westlaw.

**Working Conditions**: Occasional overnight travel

At USLI, our goal is to strengthen our community and culture by representing all races, genders, religions and sexual orientations. We continue to move conversations about diversity, equity and inclusion forward to ensure every community member has a sense of belonging, a voice and a seat at the table.

USLI provides full-time community members with a comprehensive benefits package, access to wellness programs, continuing education resources, and multiple opportunities to get involved with charitable organizations.

**Benefits**:

- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance

Schedule:

- Monday to Friday

Work setting:

- In-person

Work Location: In person

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