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Acadia Insurance (a Berkley Company) · 3 months ago

Technical Claims Specialist

US-TX-Houston

Full-time

Onsite

Mid, Senior Level

$90K/yr - $140K/yr

7+ years exp

Berkley Oil & Gas is an insurance underwriting manager focused on providing unique property and casualty products and risk services to the energy sector. The Technical Claims Specialist will handle and resolve various types of claims, including commercial general liability and worker’s compensation, ensuring compliance with company policies and state regulations.

Commercial InsuranceInsurance

No H1B

Responsibilities

Conduct and manage the investigative process, while demonstrating ongoing communication with the customer and relevant internal and external parties

Documenting files to include all key activities, contacts made, statements taken, including a full outline covering all aspect of the claim requirements for resolution

Demonstrate understanding of medical terms, medical treatment and injury descriptions

Recognition and evaluation of potential damages related to injuries

Manage the claim authorization process

Conduct complete investigation of losses through appropriate techniques including interviews, recorded statements, documentation/data gathering and securing/preserving evidence

Evaluate compensability and exposure; identify subrogation opportunities or suspicious claims. Prepare timely, concise reports and state filings as required by the jurisdiction

Promptly establish and maintain accurate reserves. Adhere to state regulatory compliance requirements

Verify, analyze, and correctly apply coverage

Develop strategy and negotiate claims to a timely conclusion, properly applying state compliance and company policies and procedures

Develop a resolution plan (e.g. pay, deny, dispute) based upon analysis of the facts, defenses, compensability, and statutory/case law

Keep policyholders, underwriting and agents advised of file status and other matters as required

Participation in presentations, meetings, or visits to agents, policyholders, prospective accounts and other groups related to claims resolution, service or technical issues

Successfully complete relevant continuing education as required

Qualification

Texas claims adjuster licenseMulti-line claims experienceNegotiation skillsContractual Risk TransferCritical thinkingComputer proficiencyCommunicationOrganizational skillsProblem-solving