Complex Claims Consulting Director

2 months ago

Lake Mary, Florida, United States CNA Full time
Job Title: Complex Claims Consulting Director

CNA is seeking a highly skilled and experienced Complex Claims Consulting Director to join our team. As a key member of our organization, you will be responsible for managing complex and high-exposure Lawyers Professional Liability Claims.

Key Responsibilities:
  • Manage and oversee all aspects of claim handling, including coverage determinations, investigations, and resolution strategies.
  • Ensure exceptional customer service by driving continuous improvements for all aspects of the claim/account.
  • Verify coverage, set and manage timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel as needed.
  • Lead all activities involved with a focused investigation to determine compensability, liability, and covered damages.
  • Drive the resolution of claims by collaborating with internal and external business partners to develop, own, and execute a claim resolution strategy.
  • Establish and manage significant claim budgets by identifying, selecting, and actively managing appropriate resources.
  • Discover and address subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making appropriate referrals to appropriate Claim, Recovery, or SIU resources for further investigation.
  • Achieve quality standards by effectively managing each claim to ensure that all company protocols are followed, work is accurate and timely, all files are properly documented, and claims are resolved and paid timely.
  • Prepare and present high-profile, complex information to senior leadership, customers, counsel, and others by effectively identifying high-profile matters, developing executive loss summaries, coordinating and communicating resolution strategies, and sharing relevant current events and case law.
  • Maintain subject matter expertise and ensure compliance with state/local regulatory requirements by following company guidelines and staying current on commercial insurance laws, regulations, or trends for the specialized line of business.
  • Mentor, guide, develop, and deliver training to less experienced Claim Professionals and may assist with special projects as needed.
Requirements:
  • Expert knowledge of the professional services industry, ideally Lawyers Professional Liability claims, policy language, coverage, and claim practices.
  • Excellent verbal and written communication skills with the ability to develop collaborative working relationships, articulate very complex claim facts, analysis, and recommendations in a concise manner to senior management, as well as with external business partners and customers.
  • Demonstrated analytical and investigative mindset with critical thinking skills and ability to make sound business decisions and to effectively evaluate and resolve ambiguous, complex, and challenging business problems.
  • Extensive experience in leading complex negotiations, as well as developing and implementing resolution strategies.
  • Strong work ethic, with demonstrated time management, organizational skills, and an ability to work independently in a fast-paced environment.
  • Ability to drive results by taking a proactive long-term view of business goals and objectives.
  • Extensive experience interpreting commercial insurance policies and coverage.
  • Ability to partner with internal resources, oversee/manage outside counsel, and collaborate with other carriers.
  • Ability to lead multiple and shifting priorities in a fast-paced and challenging environment.
  • Knowledge of Microsoft Office Suite and ability to learn business-related software.
  • Demonstrated ability to value diverse opinions and ideas.
  • Bachelor's degree with JD preferred in a related discipline or equivalent.
  • Typically a minimum ten years of relevant experience.
  • Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.
  • Advanced negotiation experience.
  • Professional designations are highly encouraged (e.g. CPCU).

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