Claims Specialist III – Construction Defect
Location: Remote (Based in Los Angeles, CA)
Length of assignment: 3 months with the opportunity of full time for the right candidate
Schedule: Monday – Friday, 1st shift
Pay Rate: $48 – 52/hourly
Summary:
This individual contributor position works under general direction, and within broad authority limits, to manage commercial claims with high complexity and exposure for a specific line of business. Responsibilities include the coordination of all claim resolution activities under both occurrences based CGL policies and claims made E & O policies according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s).
Essential Duties & Responsibilities:
- Performs a combination of duties in accordance with departmental guidelines:
- Manages highly complex investigations of claims, including coverage issues, liability, compensability and damages. Determines if a major claim should be settled or litigated and implements an appropriate resolution strategy accordingly. Effectively manages loss costs and claim expenses.
- Manages all types of investigative activity or litigation on major claims, including the posting of appropriate reserves in a timely manner. Coordinates discovery and litigation strategy with staff counsel or panel attorneys.
- Negotiates highly complex settlement packages, and authorizes payment within scope of authority, settling claims in most cost-effective manner and ensuring timely issuance of disbursements.
- Coordinates third party recovery with subrogation/salvage unit.
- Makes recommendations on claims processes and resolution strategies to management.
- Analyzes claims activities; prepares and presents reports to management and other internal business partners and clients.
- Works with attorneys, account representatives, agents, doctors and insureds regarding the handling and/or disposition of highly complex claims.
- Keeps current on state/territory regulations and issues, industry activity and trends. May participate in industry trade groups.
- Provides guidance and assistance to less experienced claims staff and other functional areas.
- Responsible for input of data that accurately reflects claim circumstances and other information important to our business outcomes.
Required Skills:
- Advanced technical and product specific expertise, claims resolution skill and knowledge of insurance and claims principles, practices and procedures.
- Strong communication, negotiation and presentation skills. Ability to effectively interact with all levels of internal and external business partners.
- Advanced analytical and problem-solving skills, with the ability to manage and prioritize multiple projects.
- Ability to deal with ambiguous situations and issues.
- Creativity in resolving unique and challenging business problems.
- Knowledge of Microsoft Office Suite and other business-related software.
- Ability to adapt to change and value diverse opinions and ideas.
- Ability to manage and prioritize multiple projects.
- Ability to evaluate claims based on a cost benefit analysis.
- Ability to fully comprehend complex claim facts and issues; and to further articulate analyses of claims in presentations to business partners and management as well as in internal reports.
- Ability to implement strategies with a proactive long-term view of business goals and objectives.
Education:
- Bachelor’s Degree or equivalent experience.
- Typically, a minimum of eight years of relevant experience, preferably in claim handling.
- Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.
- Professional designations are a plus (e.g. CPCU)