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James River Insurance Company · 19 hours ago

Claims Specialist - New York Labor Law

Richmond, VA

Full-time

Onsite

Senior Level

7+ years exp

James River Insurance Company is an established player in the insurance industry, focusing on providing innovative solutions for commercial property and casualty customers. The Claims Specialist will manage a caseload of moderate to high complexity New York Labor Law commercial insurance claims, ensuring compliance with state regulations and providing exceptional customer service throughout the claims process.

FinanceFinancial ServicesInsurance

No H1B

U.S. Citizen Only

Responsibilities

Continuously exhibit and uphold Core Values of Integrity, Accountability, Communication and Teamwork, Innovation and Customer Service

Perform coverage, liability, and damage analysis on all claims assignments

Investigate allegations and determine facts based on evidence and interviews

Draft disclaimers and reservation of rights letters when coverage issues arise

Assign limited investigations and appraisals to licensed insurance professionals

Manage a caseload of moderate to high complexity claims with delegated authority

Manage litigated files

Negotiate settlements, mitigate losses, and control expenses

Participate in and attend mediations to facilitate settlements

Maintain accurate documentation in claim files

Prepare correspondence to all required parties involved in a claim

Provide technical guidance, assistance, and training to Claims Associates and Claims Examiners

Provide exceptional customer service to insureds, claimants, and attorneys, addressing inquiries, concerns, and providing regular updates on claim status

Ensure compliance with state regulations, industry standards, and best practices in claims handling, maintaining a high level of professionalism and integrity

Maintain a passing quality assurance score on all audits and QAs

Handle claims in accordance with established James River Claims Best Practices

Other duties as required by management

Qualification

Claims handling expertiseNew York Labor LawP&C insurance knowledgeMS Office proficiencyNegotiation skillsCustomer serviceTechnical guidanceWritten communicationVerbal communicationOrganizational skillsProblem-solving skillsTeamworkAttention to detail

Required

High school diploma required

Minimum of seven years of New York Labor Law claims handling experience including working with complex coverage issues, handling liability and coverage issues, multi-jurisdictional claims, and negotiating settlements with claimants and attorneys required

Expertise in claim handling and suit management

Moderate to advanced knowledge of P&C insurance industry

Ability to effectively assess risk

Proficiency in MS Office (Word, Excel, Outlook)

Excellent written and verbal communication skills

Excellent organizational skills

Ability to take direction from management

Ability to work independently and take initiative

Ability to exercise sound judgement in making critical decisions

Research, analysis and problem-solving skills

Strong negotiation skills

Ability to build effective relationships with business partners

Ability to perform effectively as part of a team

Ability to organize complex information and pay close attention to detail

Ability to anticipate customer needs and take initiative to meet those needs

Ability to train and provide technical guidance to less experienced Claims professionals

Ability to successfully obtain the required state adjusters' licenses within six (6) months following the completion of Company-provided licensure training courses and maintain appropriate licensure thereafter