7+ years of progressive technical claim experience.
Detail-oriented with strategic decision-making skills.
Thorough knowledge of litigated claim handling.
Proficient in Microsoft Office tools, especially Word and Excel.
Strong analytical and communication skills.
Ability to maintain valid adjusters' license(s) in assigned states.
Responsibilities
Investigate and assess claims for coverage and damages.
Manage claims proactively for optimal outcomes.
Evaluate claims to set timely reserves throughout their lifecycle.
Coordinate with outside counsel and vendors for claim management.
Prepare notifications for underwriters on large claims.
Review and approve TPA funding requests within authority.
Participate in audits to monitor TPA performance.
Benefits
Hybrid working arrangement.
Non-contributory 401k plan.
Discretionary bonus opportunities.
Comprehensive medical, dental, and vision insurance.
Focus on employee wellbeing with various health benefits.
Full Job Description
Job Description
The Role
Directly 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 benefits We 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.
