Claims Specialist
2 weeks ago
Claims Specialist - Executive Claims Specialist
Alpharetta, GA, USA * Raleigh, NC, USA * Richmond, VA, USA * Scottsdale, AZ, USA * Virtual
Req #84
Wednesday, April 10, 2024
Come grow with James River Insurance
James River Insurance is an excess and surplus lines segment of James River Group Holdings, Ltd. and operates on an approved non-admitted basis in 50 states and Washington, DC. Since 2003, James River has provided thousands of commercial property and casualty customers with innovative and creative solutions for particular insurance needs.
At James River Insurance, we are committed to providing a stable and rewarding work environment supported by our Core Values and Guiding Principles: Integrity, Accountability, Innovation, Customer Service, Communication, and Teamwork.
We are proud of our recent national recognition as a 2023, 2022, and 2021 Top Workplaces USA awards.
James River Group Holdings, Ltd. is a Bermuda-based insurance holding company which owns and operates a group of specialty insurance and reinsurance companies. The Company operates in three specialty property-casualty insurance and reinsurance segments: Excess and Surplus Lines, Specialty Admitted Insurance and Casualty Reinsurance. The Company tends to focus on accounts associated with small or medium-sized businesses in each of its segments. Each of the Company's regulated insurance subsidiaries are rated "A-" (Excellent) by A.M. Best Company.
Job Summary
The Claims Specialist will manage a caseload of pending insurance claims with minimal supervision.
Job functions include the following:
Analyzing insurance claims to determine applicable coverage; Analyzing claims to determine the extent of the insured's or insurer's liability; Reviewing and evaluating damages and determining strategies for resolution; settling claims in accordance with policy provisions and within authority level.
The Claims Specialist will engage in verbal and written communication with brokers, claimants and policyholders. The Claims Specialist will ensure that state claims handling requirements are met, and internal guidelines are followed. The Claims Specialist will handle claims in accordance with James River Claims Best Practices. The Claims Specialist will function independently and will act as a resource person and consultant on issues within area of specialty.
Duties and Responsibilities
Continuously exhibit and uphold Core Values of Integrity, Accountability, Communication and Teamwork, Innovation and Customer Service
Perform coverage, liability, and damage analysis on all claims assignments
Investigate allegations, determine facts based on evidence and interviews
Draft disclaimers and reservation of rights letters when coverage issues arise
Assign limited investigations and appraisals to independent licensed professionals
Negotiate settlements, mitigate losses, and control expenses
Manage litigated files in accordance with Litigation Management Guidelines
Provide technical guidance, assistance and training as needed for claims staff and other departments
Maintain a high level of communication with leadership
Work within authority limits on assignments that reflect a high degree of technical complexity and coordination
Will be recognized as the company consultant within specialty area
Handle special projects related to specialty area as needed
Knowledge, Skills and Abilities
Excellent written and verbal communication skills
Strong analytical skills
Strong negotiation skills
Ability to work independently
Excellent organizational skills
Proficient computer skills
Ability to work in a team environment and take directions from a Claims Manager
Ability to work on assignments that require a high technical level of expertise due to complexity and exposure, under minimal supervision
Recognized as having a high level of expertise in claim handling and suit management
Ability to provide technical guidance and assistance, and train less experienced Claims Examiners
Possess demonstrated technical knowledge and skills, including product and industry, reflective of successful progress
Experience and Education
Claims Specialist
High school diploma required
College degree preferred
Advanced degree or law degree preferred
Minimum of seven years claims handling experience
Extensive expertise in specific specialty area of claims (i.e. PL, M&C, GL)
Experience working with complex coverage issues
Multi-jurisdictional claims and litigation experience
Adjuster license and/or certifications desired preferred
Executive Claims Specialist
High school diploma required
College degree preferred
Minimum of fifteen years multi-line claims handling experience, with concentration in litigation
Project management and process implementation experience preferred
Extensive expertise in specific specialty area of claims (i.e. PL, M&C, GL)
Experience working with complex coverage issues
Adjuster license and/or certifications preferred
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Other details
Job Family
Claims
Job Sub Family
Operations
Pay Type
Salary
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