Resolution Specialist

3 weeks ago

Houston, United States The Gray Insurance Company Full time

The Commercial Claims Resolution Specialist investigates commercial casualty claims. This position will gather claimant information, conduct on-scene investigations, work with outside counsel, and attend appropriate claim-related legal proceedings.

DUTIES AND RESPONSIBILITIES

  • Investigate commercial Casualty claims, including Auto and General Liability performing on-scene/site investigations when appropriate
  • Verify coverage of incoming claims and oversee the accuracy of claim set-up
  • Obtain initial medical reports, appraisals, and statements from claimants/witnesses
  • Monitor incoming medical/legal reports and respond accordingly
  • Obtain expert opinions as needed
  • Complete timely reports and claim file diaries
  • Effect settlements within prescribed limits
  • Ensure timely claim payments
  • Maintain accurate claim file reserves
  • Submits recommendations to Claims manager on cases exceeding settlement authority
  • Manage outside counsel regarding strategy on litigated claims, making sure Claims management is involved on those above authority level
  • Attend and participate in mediation
  • Attend trials, giving testimony as needed
  • Monitor vendor participation and apply gained knowledge/results appropriately
  • Pursue all viable avenues of subrogation
  • Visit assigned insureds at least once quarterly or as needed
  • Ensure up-to-date knowledge and application of statutory/regulatory laws along each coverage line
  • Ensure accurate Medicare Section 111 compliance filings
  • Mentor, assist, and share experience/expertise with peers
  • Assist Branch Manager as needed
  • Obtain required credit hours to maintain an adjuster license
  • Other duties as assigned/ required.
REQUIRED SKILLS
  • Excellent communication skills with management, employees, and outsiders.
  • Excellent computer skills with knowledge of Microsoft Office Suite or similar software.
  • Ability to work independently with minimum supervision.

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