Claims Executive

General Search & Recruitement Published:
Location
Remote, United States of America
Job ID
Job-1333

Description

Lead Claims Practice Specialist- Product Liability Life Sciences
Overview: 

Analyzes coverage and settles moderately complex claims in one or more of Client’s specialty claims areas. Generally, incumbent does not work on workers compensation claims. 
 
Essential Duties & Responsibilities:

  • Able to manage the full-life cycle of all assigned claims files.
  • Analyzes coverage and determines defense obligations.
  • Independently conducts thorough analysis and investigations necessary to determine claims exposure and recommend appropriate settlement strategies and action plans.
  • Creates reservation of rights and coverage denial letters.
  • Negotiates settlements with clients, client attorneys, and Public Adjusters.
  • Interacts extensively with various parties involved in the claims process, and may recommend retaining the advice of outside experts as necessary.
  • Prepares reserve and settlement authority requests for client and carrier approval.
  • May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage.
  • Has a solid understanding of claims processing and the insurance brokerage business.
  • Has an in-depth understanding of the terminology and case law associated with their specialized claims niche/industry.
  • Handles claims consistent with clients’ and corporate policies, procedures and “best practices” and also in accordance with any statutory, regulatory and ethical requirements.
  • Provides guidance and/or supervision to lower level adjusters. Incumbents at this level should be able to work at full case load capacity.

Required Experience:

  • High school diploma.
  • 7 or more years related claims experience required.
  • Demonstrated ability to handle unique/challenging claims issues at a senior adjuster level.
  • Appropriately licensed and/or certified in all states in which claims are being handled.
  • Knowledge of accepted industry standards and practices.
  • Computer experience with related claims and business software.

Desired:

  • Bachelor's Degree; Juris Doctorate highly preferred
  • 10 or more years of prior experience adjusting claims in applicable specialty area preferred.
  • Product liability claim experience with strong background in life sciences including familiarity with litigation and coverage

Work Traits:

  • Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges.
  • Analytical skill necessary to make decisions and resolve issues inherent in handling of claims.
  • Ability to successfully negotiate the settlement and disposition of claims including the ability to interpret related documentation.

 

  • Max. file size: 500 MB.

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