Senior Claims Resolution Specialist
5 days ago
Job Description
Key Responsibilities:
- Manage a portfolio of complex claims, ensuring timely and adequate reserves by interpreting policy language and collaborating with coverage counsel.
- Provide exceptional customer service, interacting professionally with insureds, claimants, and business partners to achieve quality and cycle time standards.
- Conduct thorough investigations to determine compensability, liability, and covered damages by gathering information, taking statements, and working with experts.
- AUTHORIZE AND ENSURE CLAIM DISBURSEMENTS WITHIN AUTHORITY LIMIT BY DETERMINING LIABILITY AND COMPENSABILITY OF THE CLAIM, NEGOTIATING SETTLEMENTS, AND ESCALATING TO MANAGER AS APPROPRIATE.
- Identify and address subrogation/salvage opportunities or potential fraud occurrences by evaluating claim facts and making referrals to appropriate Recovery or SIU resources.
- Maintain compliance with state/local regulatory requirements by following company guidelines and staying current on commercial insurance laws, regulations, or trends for the line of business.
Requirements:
- Bachelor's Degree or equivalent experience.
- Typically a minimum four years of relevant experience, preferably in claim handling.
- Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.
- Professional designations are a plus (e.g., CPCU).
Working Relationships:
- Establish and maintain working relationships with internal and external work partners, suppliers, and experts by identifying and collaborating with resources needed to effectively resolve claims.
Skills and Knowledge:
- Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.
- Solid verbal and written communication skills with the ability to develop positive working relationships, summarize, and present information to customers, claimants, and senior management as needed.
- Ability to exercise independent judgment, solve moderately complex problems, and make sound business decisions.
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