Senior Claims Specialist – Professional Liability
Location
Massachusetts
Posted
28 days ago
Salary
$110K - $115K / year
Bachelor Degree6 yrs expEnglish
Job Description
• To analyze complex errors and omissions, directors and officers claims
• To provide resolution of highly complex nature and/or severe injury claims
• To coordinate case management within Company standards, industry best practices and specific client service requirements
• To manage the total claim costs while providing high levels of customer service
• Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions.
• Negotiates claim settlement up to designated authority level.
• Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life.
• Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement.
• Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients.
• Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost.
• Represents Company in depositions, mediations, and trial monitoring as needed.
• Communicates claim activity and processing with the client; maintains professional client relationships.
• Ensures claim files are properly documented and claims coding is correct.
• Refers cases as appropriate to supervisor and management.
• Delegates work and mentors assigned staff.
Job Requirements
- Bachelor's degree from an accredited college or university preferred.
- Licenses as required.
- Professional certification as applicable to line of business preferred.
- Six (6) years of claims management experience or equivalent combination of education and experience required.
Benefits
- medical
- dental
- vision
- 401k and matching
- PTO
- disability and life insurance
- employee assistance
- flexible spending or health savings account
- other additional voluntary benefits