Senior Claims Specialist
JOB DESCRIPTION
Job Summary
This position is exempt and reports to the Claims Team Leader. Develop and maintain client relationships through advising and providing advocacy on Property and Casualty (P&C) claims related to coverage issues. Perform claim reviews and status updates to ensure that claims are properly set up, coverage positions are received and that the claim files are moving towards closure or resolution in a timely manner. Provide routine status updates to service the team on open claims. Communicate with claims professionals, clients, and internal staff to achieve successful results.
Successful candidate will be a service-oriented individual with high personal standards and a hands-on workstyle.
Location: Van Nuys, California.
Duties and responsibilities include, but are not limited to:
• Receive new Property and Auto claims, assess coverage and communicate directly with Business Managers and Clients.
• Monitoring claim files and obtain routine status updates, including providing regular status updates to service teams.
• Respond to requests for updates or questions form the services team or clients in a timely manner.
• Review claim liabilities, assess the financial exposure of the insured reviews reserves.
• Participate in and provide advocacy on claim strategy and consult on a regular basis to assist in settlement discussions and resolution of large and complex claims.
• Identify and address steps which can be taken to transfer risk and/or subrogate claims.
• Develop final reports summarizing lifecycle of a claim, such responding to loss requests.
• Assist and facilitate the appropriate service partner to defend insured and quantify liability and damages.
• Notify insurers when a file exceeds specific criteria set by each insurer (such as cost, claim type, or complexity) to keep insurers briefed on what claims may be of high concern to them.
• Handle client’s questions or complaints and act as a mediator with the carrier.
• Provide interim and final settlement information.
• Establish and develop client and company relationships to ensure good communication for the most effective claims handling.
• Pursue programs for personal and professional development.
• Assist on developing and working with leadership and management to ensure that claims resources are deployed in the most efficient manner and to support the claims team role as coverage advocates.
• Ability to understand and interpret policy forms and coverage in order to be able to dispute claim denials, if necessary.
• Identify and address steps to be taken to deal with leak detection implementation after water losses.
Education and Experience Requirements:
• Maintain a valid Driver’s License & have reliable transportation.
• Minimum of 4 years of experience preferred, ability to understand and interpret policy forms and coverage with Property and Auto claims.
• Active Property & Casualty License, a plus
• Above average telephone personality and ability to deal with people in difficult and emotional situations.
• Ability to work collaboratively and effectively with others.
• Skill in organizing resources and establishing priorities.
• Demonstrated ability to develop, plan and implement short- and long-range goals.
• Strong negotiating skills
• Ability to work extra hours when needed.
• Must have experience with MS Office Suite (Word, Excel, Outlook)
Physical Actions:
• Required job duties are essentially sedentary work consisting of occasional walking, standing and lifting and/or carrying 10 lbs. maximum.
• Work is performed in a typical interior/office work environment.
• Travel is sometimes required to visit clients or adjusters, most often in the Los Angeles Area.
• Will be required to work in our Van Nuys office.