Job DescriptionThe RoleDirectly handles and provides oversight of professional liability claims, including review and approval of claims exceeding the TPA's authority. Analyzes coverage and ensures that appropriate coverage letters are issued. Participates in audits and ongoing review of monthly TPA reports. Works with underwriting to provide relevant information on claims, coverage and industry trends.
Responsibilities- Investigate and assess claims for coverage, damages, and pursuit of recoveries and subrogation/contribution opportunities.
- Demonstrate an in-depth understanding of coverage issues, policy forms, contracts, regulatory requirements, and legal landscape for specialty line claims.
- Proactively and promptly manage claims, considering all aspects with a strategic vision for optimal claim outcome
- Continually evaluate claims to set appropriate and timely reserves over the life of the claim
- Demonstrate strong technical claims proficiency through consistent execution of best claim practices
- Strategically coordinate and manage outside counsel and vendors to obtain optimal claim outcome
- Prepare notification to underwriters and reinsurers for large or contentious claims
- Review and approve TPA funding requests within authority
- Participate in claim file audits to monitor TPA performance
- Assist with preparation of reports for underwriting, agents, insureds or state agencies as needed
- Collaborate with internal and external business partners for client meetings, product development and improvement
- Occasional travel
- Other duties as assigned
Skills and Qualifications - Bachelor's degree; law degree preferred; seven or more years of progressive technical claim experience is required
- Detail-oriented, adaptable and strategic in decision-making.
- Thorough technical knowledge of litigated claim handling.
- Thorough functional knowledge of Microsoft Office tools, including Word and Excel
- Self-starter with the desire to work in a collaborative environment and provide insight and feedback to other departments
- Ability to communicate effectively
- Strong analytical skills
- Strong verbal and written communication skills
- Good mathematical skills with ability to compute rate, ratio and percent and to draw and interpret bar graphs and tables.
- Strong attention to detail and focused on the delivery of high-quality work
- Highly motivated, enthusiastic and structured working style
- Customer service and relationship-oriented
- Maintain valid adjusters' license(s) in states assigned or an ability to obtain same.
Salary Range: $140,000 - $180,000
Our benefitsWe offer all employees a comprehensive benefits package that focuses on their whole wellbeing. This includes hybrid working, a competitive base salary, non-contributory 401k, discretionary bonus, insurances including medical, dental and vision cover, and many other benefits to enhance financial, physical, social and psychological health.
