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Role Description

The Senior Claims Specialist works within a Claims Team, using the latest technology to review, analyze and process claims that are routinely characterized as moderately complex to complex within assigned authority limits. This position primarily manages a caseload of commercial licensed veterinarian board complaints handled under the veterinary professional liability policy. The role also involves determining liability and compensability, assessing losses, and negotiating settlements for claims including agents’ errors and omissions, employment practices liability, sexual assault and molestation, human trafficking, and employee benefits liability.

• Plans and conducts investigations of claims, including activities such as interviewing insureds, witnesses, and claimants, collecting and evaluating appropriate documentation, securing evidence, and protecting the chain-of-custody.
• Analyzes and confirms coverage to determine liability, compensability, and damages; determines need for and engages independent adjusters, cause and origin experts, and independent medical examiners.
• Refers claims to subrogation group or Special Investigations Unit as appropriate.
• 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.
• Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.
• Coordinates the litigation activities associated with assigned claims to ensure a timely and cost-effective resolution; attends trials as a representative of the company.
• Participates in conducting Roundtables, Arbitrations, Mediations, field investigations, and may assist in conducting closed file reviews.
• Performs other duties as assigned.

Qualifications

• Excellent interpersonal skills to communicate and negotiate with customers and conduct investigations required.
• Leadership ability and demonstrated time management skills to delegate work appropriately and organize resources effectively.
• Demonstrates an advanced knowledge of claims case handling practices, legal liability, general insurance policy coverage, and the state’s tort laws as normally acquired through a bachelor’s degree (or equivalent training) plus 3 to 5 years directly related work experience.
• Required to obtain and maintain all applicable licenses; Helmsman licenses are required.

Benefits

• Comprehensive benefits that support your life and well-being.
• Workplace flexibility and professional development opportunities.
• Opportunities provided through Employee Resource Groups.