Job Description

Complex Claims Specialist

Job Summary

Seeking a highly skilled and experienced Complex Claims Specialist to join a dynamic team. This role focuses on managing complex claims within the Cyber, Tech, Media, and Crime professional liability lines of business. The successful candidate will play a pivotal role in analyzing liability claim submissions, managing litigation, and driving early resolution of claims.

Compensation Package

• Salary Range: $115,000 - $150,000 per year (based on experience and qualifications)
• Benefits:
  • Competitive salary and performance-based bonus
  • Comprehensive health, vision, and dental insurance
  • 401(k) with competitive company matching

Responsibilities

• Adjust and resolve complex claims, including all phases of litigation.
• Manage and direct work of counsel and experts on claims.
• Draft complex coverage letters, including reservation of rights and denial letters.
• Review and analyze claim documentation and legal filings.
• Drive litigation best practices to lead defense strategy on litigated files.
• Investigate, negotiate, and utilize alternative dispute resolutions to achieve positive claim outcomes.
• Identify emerging exposures and claims trends.
• Accurately document claim files in compliance with company policies and regulatory requirements.
• Develop and conduct training for claims teams and underwriters.
• Handle claims from across the U.S., with an average caseload of 110-125 files (80% litigated).

Qualifications/Requirements

• 8+ years in insurance, with at least 5 years in litigation.
• Proven ability to manage claims up to $2M, with an average range of $100K-$250K.
• Advanced knowledge of claims analysis, adjusting practices, and litigation processes.
• Bachelor’s degree from an accredited college or university preferred.
• JD from an ABA-accredited law school may be considered as a supplement to claims handling experience.
• Strong analytical, negotiation, and communication skills.
• Ability to work independently with minimal supervision.
• Experience attending and leading mediations, arbitrations, and trials.
• Commitment to professional development, including certifications such as CPCU, ARMS, or AINS.
• Demonstrated ability to act as a subject matter expert.
• Courage and professionalism in addressing complex matters with insureds, attorneys, and brokers.
• Well-organized and responsive with a proactive approach to claims management.

Disclaimer: Please note that this job description may not cover all duties, responsibilities, or aspects of the role, and it is subject to modification at the employer's discretion.

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