Claims Specialist

Job Description:

Investigates, evaluates, reserves and resolves Automobile, General Liability and Property claims for self-insured and unbundled clients. Provides a superior level of customer service to internal and external business partners. Administers and resolves claims for TPA clients in a timely manner and in accordance with client, company and regulatory guidelines.

Responsibilities:

• Promptly investigates all assigned claims for coverage, liability, damages, subrogation and contribution. Ensures timely disposition of all claims in accordance with client, regulatory and statutory requirements.
• Within granted authority, establishes appropriate loss and expense reserves with documented rationale. Maintains and adjusts reserves over the life of the claim to reflect changes in exposure. Notifies appropriate claims management and clients when exposure exceeds authority. Negotiates claims resolution within granted authority.
• Establishes and executes appropriate action plans for claim resolution including loss cost management while achieving appropriate balance between allocated expense and loss outcome.
• Works collaboratively with the client and internal and external business partners in investigating and reaching appropriate disposition of all claims.
• Selects and manages service vendors to achieve appropriate balance between allocated expense and loss outcome.
• Maintains a working knowledge of regulatory and jurisdictional requirements for assigned claims territory.
• Demonstrates technical proficiency through timely, consistent execution of best claim practices and established claims handling guidelines.
• Communicates effectively with internal and external customers on claims and account issues. Provides a high degree of customer service.
• Maintain and manage a diary system and claim pending to efficiently and effectively resolve all claims.
• Potential local travel.
• Demonstrate commitment to Company’s Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.

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• FL and/or TX license required; NY license preferred.
• Bachelor's' degree and a minimum of 3 years of progressively responsible experience handling Automobile, General Liability, Professional Liability and Property claims required.
• Familiarity with coverage, negligence principles, investigation and negotiation techniques.
• Obtains and maintains state adjusting licenses, as needed. Ensures that all state-required Continuing Education Credits are obtained as needed to maintain license.
• Strong organizational skills and detail oriented.
• Ability to work independently, handle multiple tasks simultaneously and exercise good judgment.
• Working knowledge of Auto, Liability and Property claims handling practices.
• Excellent verbal and written communication skills.
• Excellent customer service skills.
• Computer literacy, including working knowledge of MS Office including Word, Excel and PowerPoint.