100% Remote Opportunity
Investigates, evaluates, disposes and settles the most complex claims and highest exposures with minimal supervision. Includes the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves. Incumbents at this level typically hold claims reserve and settlement authority of up to $10,000 liability and/or $25,000 workers compensation or greater. Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the claim. Interacts extensively with various parties involved in the claim process. Able to clearly communicate concise action plans, and present plans for moving the case to conclusion. Will demonstrate complete knowledge of the claim file process through presentation of actions and responses to client questions. Processes claims consistent with clients’ and corporate policies, procedures and “best practices” and also in accordance with any statutory, regulatory and ethics requirements. Demonstrated ability to comply with carrier reporting and threshold requirements. Able to recognize and pursue excess insurance recoveries. Incumbents will have the ability to handle a full case load, with proven ability to handle cases of increased severity.
Required: High school diploma and 5 years related claims experience required. Appropriately licensed and/or certified in all states in which claims are being handled or able to obtain the licenses/certification per local requirements. Extensive knowledge of accepted industry standards and practices. Computer experience with related claims and business software.
Preferred: Bachelor’s degree preferred.
Behaviors: Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges. Analytical skill necessary to make decisions and resolve complex issues inherent in handling losses. Ability to successfully negotiate the settlement and disposition of serious claims including the ability to interpret related documentation.