Claims Specialist

1 week ago

Alpharetta, United States Travelers Full time
About the Role

We are seeking a highly skilled Claims Specialist to join our team at Travelers. As a Claims Specialist, you will be responsible for handling severe claims and providing quality customer service to our policyholders.

Key Responsibilities
  • Directly handle assigned severe claims, ensuring timely and effective resolution.
  • Provide exceptional customer service, ensuring file quality and timely coverage analysis and communication with insureds.
  • Consult with Manager on the use of Claim Coverage Counsel as needed.
  • Investigate claims through prompt and strategically-appropriate contact with policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers, and technical experts.
  • Interview witnesses and stakeholders, taking necessary statements as strategically appropriate.
  • Complete outside investigations as needed, per case specifics.
  • Engage in the identification, selection, and direction of internal and/or external resources for specific activities required to evaluate claims.
  • Verify the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damages documentation.
  • Maintain claim files and documents claim file activities following established procedures.
  • Utilize evaluation documentation tools following department guidelines.
  • Proactively review Claim File Analysis (CFA) for adherence to quality standards and trend analysis.
  • Utilize diary management systems to ensure timely handling of all claims.
  • Evaluate liability and damages exposure at required time intervals.
  • Establish and maintain proper indemnity and expense reserves.
  • Recommend cases for discussion at roundtable.
  • Attend and/or present at roundtables/authority discussions for collaboration of technical expertise.
  • Share experience and knowledge of creative resolution techniques to improve claim results.
  • Develop and employ creative resolution strategies.
  • Promptly and properly dispose of all claims within delegated authority.
  • Negotiate disposition of claims with insureds and claimants or their legal representatives.
  • Recognize and implement alternate means of resolution.
  • Manage litigated claims, developing a litigation plan with staff or panel counsel.
  • Apply litigation management through selection of counsel, evaluation, and direction of claim and litigation strategy.
  • Track and control legal expenses to assure cost-effective resolution.
  • Effectively and efficiently manage allocated and unallocated loss adjustment expenses.
  • Attend depositions, mediations, arbitrations, pre-trials, trials, and all other legal proceedings as needed.
  • Update appropriate parties as needed, providing new facts.
  • Acquire and maintain Insurance License(s) to comply with state and Travelers requirements.
Requirements
  • Bachelor's Degree preferred.
  • Skilled in coverage, contract interpretation, liability and damages analysis with a thorough understanding of the litigation process, relevant case and statutory law, and expert litigation management skills.
  • Extensive claim and/or legal experience and technical expertise to evaluate severe and complex claims.
  • Able to make independent decisions on most assigned cases without involvement of supervisor.
  • Thorough understanding of business line products, policy language, exclusions, ISO forms, and effective claims handling practices.
  • Openness to the ideas and expertise of others, actively soliciting input, and sharing ideas.
  • Strong negotiation and customer service skills.
  • Demonstrated coaching, influence, and persuasion skills.
  • Strong written and verbal communication skills to understand, synthesize, interpret, and convey complex data and information to audiences with varying levels of expertise.
  • Strong technology aptitude, ability to use business technology tools to effectively research, track, and communicate information.
  • Attention to detail ensuring accuracy.
  • Job Specific Technical Competencies:
  • Analytical Thinking.
  • Judgment/Decision Making.
  • Communication.
  • Negotiation.
  • Insurance Contract Knowledge.
  • Principles of Investigation.
  • Value Determination.
  • Settlement Techniques.
  • Legal Knowledge.
  • Medical Knowledge.
What We Offer
  • Health Insurance: Employees and their eligible family members are eligible for coverage from the first day of employment.
  • Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum.
  • Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
  • Wellness Program: The Travelers wellness program is comprised of tools, discounts, and resources that empower you to achieve your wellness goals and caregiving needs.
  • Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved.

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