Responsibilities
The Senior Complex Claims Specialist investigates, evaluates, negotiates, and resolves complex and high-exposure litigated and non-litigated claims across bodily injury, property damage, personal and advertising injury, and professional liability lines.
• Analyze coverage, identify coverage issues, and prepare coverage letters for supervisor approval• Investigate and evaluate liability• Investigate and evaluate damages• Manage litigation by assigning counsel from the approved panel where applicable, establishing litigation plans and budgets, coordinating with defense counsel, and continuously reviewing the potential for resolution• Establish timely reserves within authority and re-evaluate throughout the life of the claim• Maintain up-to-date, appropriate file documentation and written file notes• Maintain an active diary and productive file inventory• Timely complete all required large loss reporting• Negotiate settlements within authority limits and attend mediations, Mandatory Settlement Conferences, and/or Alternative Dispute Resolutions• Proactively control the work product and expense of outside vendors• Develop and maintain positive customer relationships and provide superior customer service• Timely identify all potential opportunities for co-insurance, transfer of risk, and/or subrogation• Work with designated assigned accounts• Recognize and investigate fraud• Comply with deductible/self-insured retention recovery protocol• Meet all State licensing requirements• Adhere to all statutory regulations, Unfair Claims Practices acts, and corporate Best Practices• Serve as mentor for claims associates and provide technical advice• Assist management with administrative tasks as needed• Perform other duties as assigned
Qualifications
Qualifications:
• Eight (8) or more years of claims handling experience or equivalent experience• In-depth knowledge of the insurance industry, including legal and regulatory environments• Specific knowledge and expertise in New York Labor law and construction-related claims (preferred)
Education Requirement
• Four (4) year college degree, or commensurate experience and training• JD preferred• Industry designations preferred (e.g., CRIS, AIC, SCLA)• New York adjuster’s license a plus
Additional Company DetailsWe do not accept unsolicited resumes from third party recruiting agencies or firms.
Additional RequirementsLocation and Travel: • Atlanta, GA.
Sponsorship DetailsSponsorship not Offered for this Role
