Claims Specialist

4 days ago

Jersey City, United States Combined Insurance Full time

The Claim Specialist, under moderate direction from the manager, investigates and settles claims promptly, equitably, and within established best practices guidelines.

**Scope**
- Responsible for investigating; settling high exposure, high risk Employment Practices Claims.
- Ensure a high level of customer service and claim file quality.
- Identifying and evaluating coverage issues, preparing comprehensive coverage letters and analysis, retaining and managing coverage counsel through trial, and developing and managing strategy for complex coverage litigation.
- Evaluating exposure through an in-depth analysis of legal and factual issues, retaining and managing litigation counsel through trial, developing and managing strategy for complex litigation.
- Attending arbitrations, mediations, trials.
- Developing resolution strategies and negotiating settlements.
- Reviewing legal budgets and legal and third-party vendor’s bills.
- Presenting litigation strategy for complex litigation to senior claims management and underwriting staff.
- Support business leaders on an as needed basis on various claim and underwriting related issues and marketing meetings.

**Responsibilities**

Duties may include, but are not limited to:

- Day-to-day handling of substantial caseload of line of employment practices liability claims.
- Confirm coverage of claims by reviewing policies and documents submitted in support of claims.
- Analyze coverage and communicate coverage positions, as warranted, under direction of supervisor and coverage unit.
- Conduct, coordinate, and direct investigation into loss facts and extent of third-party damages.
- Direct and monitor assignments to experts and underlying defense counsel.
- Evaluate information on coverage, liability, and damages to determine the extent of insured's exposure.
- Set reserves within authority or make claim recommendations concerning reserve changes to supervisor.
- Report to reinsurers and facilitate the prompt collection of reinsurance on those matters where they are accountable.
- Ability to handle demanding caseload of claims pertaining to Employment Practices Liability and provide business support.
- Approximately 2-4 years experience in EPL or handling claims of a comparable complexity or working in a legal position with experience evaluating and resolving matters.
- Law degree preferred.
- If you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure.

**Desired Traits**
- Excellent interpersonal communications and negotiation skills.
- Ability to deal with customers in a professional manner.
- Authoritative knowledge of CHUBB coverage, products, services, and liabilities.
- Ability to self-motivate and self-start.
- Ability to make independent decisions using CHUBB best practices for guidance.
- Excellent verbal and written communication skills.
- Strong interpersonal, negotiation and customer service skills.
- Capable of dealing with highly visible and demanding customers.
- Highly organized and able to respond to insureds and internal and external business partners in a timely manner.
- Must be able to effectively work in a team environment.
- The Claim Specialist, under some direction from the manager, investigates and settles claims promptly, equitably and within established best practices guidelines.

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