Senior Casualty Claims Representative

Company Details

 

Acadia Insurance is a regional property casualty insurer with offices throughout the Northeast.  As a member of W.R. Berkley Corporation (NYSE: WRB), one of the largest property casualty insurance holding companies in the United States, our financial strength and integrity are two of the main reasons why Independent Agents place business with us.  Acadia is rated A+ (Superior) by A.M. Best, with an A+ claim paying ability rating by Standard & Poor’s. 

 

At Acadia, we value our employees, our customers and our communities.  Employees at Acadia are part of a progressive company where everyone can make a difference.  We promote an inclusive environment which encourages continuous learning and the chance to grow and develop. 

 

Company URL: https://www.acadiainsurance.com/

Responsibilities

Investigate, evaluate and resolve assigned claims in accordance with company standards, procedures, and state regulatory requirements.

 

• Perform investigations in a timely and thorough manner to ensure accurate decisions on coverage, compensability, liability, and damage issues affecting claim resolutions.
• Effectively negotiate with insureds, third-parties and claimants listening carefully to their demands and using an objective approach to resolve the claim fairly.
• Control file-related expenses through efficient utilization and monitoring of "outside" vendors.
• Inform other departments of positive/negative conditions noted during investigations which may impact company results.
• Manage existing workloads effectively to achieve quality and quantity production goals while providing superior customer service.
• Participate in special account reviews and present agents and insureds with recommendations for improving their loss ratio and information on best practices.
• Steadily increase complexity and proficiency including more complex coverage and/or compensability disputes, contractual risk transfer, liability/subrogation investigations, negotiations, and strategic resolution practices.  Engage appropriately with agents and insureds in increasingly complex discussions and capable of leading synergy meetings.
• In addition to demonstrating increased proficiency with systems and workflows, actively engage in roundtable discussions, Synergy meetings and on-site investigations.
• Possess understanding of litigation competencies.
• Assist in the training and development of claim personnel as needed.
• Under general direction, handles complex cases and those involving complex questions of coverage, compensability, legal liability and damages. 
• Handles complex bodily injury, property damage and workers’ compensations cases utilizing experts and outside firms as required. 
• Works closely with underwriting in developing and interpreting policy language and, in conjunction with loss control, assists in the analysis and recommendations on loss sensitive and special accounts. 
• May serve as team leader or mentor in the training and development of less experienced staff and provides input in roundtable discussions. 
• Attends settlement conferences, trials and mediations on a regular basis.
• Demonstrate professionalism and promote Acadia's values and presence as a Trusted Advisor internally and externally.
• Have a strong understanding of the business of insurance outside of the claims discipline.
• Significant independence in claims handling of the most complex claims not requiring major case unit/specialty handling. 
• Effectively mentor staff including providing direction for claims handling strategies within their authority. 
• Exhibit initiative, a team minded attitude, be proactive in anticipating areas of concern. 

Qualifications

Bachelor's degree (B. A.) and minimum of 5-7 years of related experience and/or training; or equivalent combination of education and experience.

 

• Minimum of 5-7 years of progressive property & casualty and/or workers' compensation claims handling experience, including complex liability and coverage investigations.
• Demonstrated expertise in investigating, analyzing, and resolving complex claims involving coverage disputes, compensability issues, legal liability, bodily injury, property damage, and workers' compensation exposures.
• Strong knowledge of insurance policies, contract interpretation, contractual risk transfer, subrogation, litigation management, and claim resolution strategies.
• Proven ability to negotiate effectively with claimants, attorneys, insureds, agents, and third parties to achieve fair and cost-effective settlements.
• Experience managing litigation, including attending mediations, settlement conferences, arbitrations, and trials, and coordinating with defense counsel and expert witnesses.
• Thorough understanding of insurance regulations, state statutes, claims best practices, and industry standards.
• Ability to evaluate damages, reserves, settlement values, and claim exposures while maintaining authority limits and company guidelines.
• Experience utilizing independent adjusters, investigators, medical providers, attorneys, engineers, and other vendors to support claim investigations and control expenses.
• Strong analytical and critical thinking skills with the ability to make sound decisions on complex and high-exposure claims.
• Demonstrated ability to manage a large and diverse caseload while achieving quality, productivity, and customer service objectives.
• Excellent written and verbal communication skills with the ability to present recommendations and build credibility with insureds, agents, attorneys, and internal business partners.
• Proven ability to collaborate effectively with underwriting, loss control, legal, and other departments to identify trends and improve business outcomes.
• Strong leadership, mentoring, coaching, and training skills with experience supporting the development of less experienced claims professionals.
• Ability to facilitate roundtable discussions, lead claim strategy meetings, and contribute to organizational initiatives and special projects.
• Advanced proficiency with claims management systems, Microsoft Office applications, and other insurance technology platforms.
• Demonstrated ability to work independently, exercise sound judgment, and manage highly complex claims with minimal supervision.
• Strong business acumen with a broad understanding of insurance operations, underwriting principles, loss control practices, and agency relationships.
• Professional designations such as CPCU, AIC, ARM, SCLA preferred.
• Relevant state adjuster license(s) required.
• Proven record of professionalism, integrity, initiative, and commitment to delivering trusted advisor-level service to internal and external stakeholders.
• Ability to identify emerging risks, anticipate issues, and proactively develop claim handling and resolution strategies while fostering a collaborative, team-oriented work environment.

 

The Company is an equal employment opportunity employer. 

Additional Company Details

We do not accept unsolicited resumes from third party recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees including: • Base Salary Range: 90k-$110k • Eligible to participate in annual discretionary bonus • Benefits include: Health, dental, vision, dental, life, disability, wellness, paid time off, 401(k) and profit-sharing plans The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.

Sponsorship Details

Sponsorship not Offered for this Role