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Complex Claims Specialist

2 months ago

Chicago, Illinois, United States Argo Group Full time
Job Description

Argo Group is a leader in specialty insurance with a vibrant culture built on respect, equality, wellness, and opportunity. We're an innovative organization that's small enough to be agile and big enough to make a difference in our industry.

Our flexible workplace is continuously evolving to ensure all employees feel:

  • Comfortable bringing their whole selves to work.
  • Confident that they will be treated respectfully.
  • Recognized for their performance and provided with equal opportunities to succeed.

At Argo, skill meets opportunity. If you're wired to raise your hand and ask, 'Where can I help?', you'll thrive with us.

Argo Group, a global multiline underwriter of specialty insurance and reinsurance products in the property and casualty market, offers a comprehensive line of high-quality products and services designed to meet the unique coverage and claims-handling needs of our clients. We foster an inclusive culture that embraces diversity and design thinking, relies on innovation and agility, promotes collaborative service delivery, frequent, integrated communication, and authentic recognition of excellence.

A Brief Overview

We are looking for a highly capable Complex Claims Technical Specialist to join our team and work in our offices. This role will directly report to the SVP, Claims Legal and is responsible for providing technical support on major cases in litigation assigned to Adjusters throughout the US.

**Key Responsibilities:**

  • Working with limited oversight under broad management direction, adjudicate highly complex claims, at the highest authority limits on assignments reflecting the highest degree of technical complexity and coordination in liability and litigated claims, potentially with major impact on departmental results.
  • Conducting detailed information gathering, analysis, and investigation to find solutions to issues that are numerous and undefined.
  • Oversee defense panelist, including monitoring and evaluating operations and performance.
  • Conduct file reviews to ensure accuracy, attend mediations and settlements, and participate in pre-trial calls as necessary.
  • Provide technical guidance in properly setting claim reserves.
  • Reporting to senior management and underwriters on claims trends and developments.
  • Investigating claims promptly and thoroughly.
  • Analyzing claims forms, policies, and endorsements, client instructions, and other records to determine whether the loss falls within the policy coverage.
  • Investigating claims promptly and thoroughly, including interviewing all involved parties.
  • Managing claims in litigation.
  • Managing diary timely and complete tasks to ensure that cases move to the best financial outcome and timely resolution.
  • Properly setting claim reserves, taking into account how different policy wordings impact the claims reserving process.
  • Identifying, assigning, and coordinating the assignment and coordination of expertise resources to assist in case resolution.
  • Preparing reports for file documentation.
  • Applying creative solutions which result in the best financial outcome.
  • Negotiates highly complex settlement packages, sets reserves, and authorizes payment within scope of authority, settling claims in the most cost-effective manner and ensuring timely issuance of disbursements.
  • Processing mail and prioritizing workload.
  • Completing telephone calls and written correspondence to/from various parties (insured, claimant, etc.).
  • Having an appreciation and passion for strong claim management.

**Requirements:**

  • J.D. from an accredited law school.
  • A deep knowledge of claims adjudication is typically achieved through a minimum of seven years' experience adjudicating claims with exposure of $100,000 or more.
  • Must have good business acumen (i.e., understand how an insurance company works and makes money, including how this role impacts both Argo Group and our customers' ability to be profitable).
  • Ability to regularly exercise discretion and independent judgment with respect to matters of significance. This role primarily faces problems and issues that are difficult and require an understanding of a broader set of issues.
  • Must have excellent communication skills and the ability to build lasting relationships.
  • Exhibit natural curiosity in order to consistently explore and consider all options and is not governed by conventional thinking.
  • Desire to work in a fast-paced environment.
  • Excellent evaluation and strategic skills required.
  • Strong claim negotiation skills a must.
  • Knows how claims reserving techniques are used and how to assess whether a claim reserve is accurate.
  • Must possess a strong customer focus.
  • Effective time management skills and ability to prioritize workload while handling multiple tasks and deadlines.
  • Demonstrates innovative thinking and regularly shares ideas to help the team whenever possible.
  • Ability to articulate the financial value of your work at multiple responsibility levels inside our clients' business which may include CEO.
  • Demonstrates inner strength. Has the courage to do the right thing and demonstrates it on a daily basis.
  • Intellectual curiosity. Consistently considers all options and is not governed by conventional thinking.
  • Proficient in MS Office Suite and other business-related software.
  • Polished and professional written and verbal communication skills in order to present information accurately and effectively.
  • The ability to read and write English fluently is required.
  • Must demonstrate a desire for continued professional development through continuing education and self-development opportunities.
  • Licensed Claims Examiner (Based on state) Must possess or have ability to quickly obtain a license in each jurisdiction requiring a license to adjudicate first-party claims within 120 Days.

**About Working in Claims at Argo Group:**

  • Argo Group does not treat our claims or our claims professionals as a commodity. The work we offer is challenging, diverse, and impactful.
  • Our Adjusters and Managers are empowered to exercise their independent discretion and, within broad limits and authority, be creative in developing solutions and treat each case as the unique situation it is.
  • We have a very flat organizational structure, enabling our employees have more interaction with our senior management team, especially when it relates to reviewing large losses.
  • Our entire claims team works in a collaborative nature to expeditiously resolve claims. We offer a work environment that inspires innovation and is open to employee suggestions. We even offer rewards for creative and innovative ideas.
  • We believe in building an inclusive and diverse team, and we strive to make our office a welcoming space for everyone. We encourage talented people from all backgrounds to apply.

**Our Employee Values:**

Employees at Argo thrive together as a responsible, profitable specialty insurer where all stakeholders share in our success.

We are committed to:

  • **Demonstrate Entrepreneurial Spirit:**
    • Get the job done in a non-bureaucratic, resourceful manner.
    • Create a culture of accountability ensuring the delivery of world-class products and services.
  • **Do the Right Thing:**
    • Act with integrity always.
    • Adhere to the commitments set forth in the Argo Group Environmental, Social, and Governance program.
  • **Collaborate:**
    • Create an open and transparent environment in which diverse experience, skill sets, and individuals can team together to drive optimal outcomes.
    • Encourage and include unique perspectives at all times.
  • **Respect Each Other:**
    • Create an environment that promotes dialogue, mutual support, and cooperation between and among all, where people are fun to be around, proud of what they do, and willing to achieve beyond normal expectations.