Claims Specialist II

Description

The Claims Specialist works within a Claims Team, using the latest technology to manage an assigned caseload of routine to moderately complex claims from the investigation of the claim through resolution. This includes making decisions about liability/compensability, evaluating losses, and negotiating settlements. The role interacts with claimants, policyholders, appraisers, attorneys, and other third parties throughout the claim’s management process. The position offers training developed with an emphasis on enhancing skills needed to help provide exceptional service to our customers.

 

This is a hybrid position. Candidates within 50 miles of select offices are expected in-office 2 Days per Month

 

Responsibilities:

• Manages an inventory of claims to evaluate compensability/liability.
• Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources.
• Manages litigated claims involving bodily injury and property damage exposures within the commercial lines of business, collaborating with insureds, claimants, attorneys, and other involved parties throughout the litigation and claims-handling process.
• Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability and damages.
• Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate.
• Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.
• Performs other duties as assigned.

Qualifications

• BS/BA degree or equivalent work experience.
• Minimum of 2 years experience in claims adjustment, general insurance or formal claims training.
• Required to obtain and maintain all applicable licenses.
• Continuing education courses leading to industry certifications preferred (e.g., AEI, IIA, CPCU).
• Knowledge of claims investigation techniques, medical terminology and legal aspects of claims.

 

Employees may apply for a new role after completing 12 months of employment in their current position.

 

Employees should review all role requirements and apply only for positions for which they are eligible. Hiring processes may vary by country, including differences in procedures, requirements, and timelines.  For country-specific details, please consult your local recruiting / HR team.