Complex Claims Specialist jobs in United States
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Berkley Technology Services · 12 hours ago

Complex Claims Specialist

Berkley is a member company of W. R. Berkley Corporation, a leading insurance holding company in the United States. They are seeking a Complex Claims Specialist who will ensure high-quality claim handling, analyze liabilities, and move cases towards timely resolution while providing operational support to the claims team.

Information TechnologyProject ManagementSoftware
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Responsibilities

The primary role of a Complex Claims Specialist is to promptly and professionally ensure high quality claim handling by analyzing liability of claim submissions while making coverage determinations, investigating losses, conducting independent assessment as to the insured’s exposure and moving cases towards timely resolution
You will be an effective source for help and support because of your deep knowledge and liability claim expertise
The Complex Claims Specialist is a high-level adjuster role that adjudicates assigned claims within given authority and provides operational support to the claims team
Adjusts and resolves complex to severe commercial claims that may also include all phases of litigation for our Bodily Injury team
Plans and conducts investigations of high severity claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages; determines need for, and engages independent adjusters, cause and origin experts and independent medical examiners
Refers to claim to subrogation group or Special Investigations Unit as appropriate
Assesses policy coverage for submitted claims and notifies the insured of any issues
With minimal supervision, drafts complex coverage letters, including reservation of rights and denial letters
Determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim
Reviews and analyses claim documentation and legal filings
Assesses actual damages associated with claims and confidently conducts negotiation within assigned authority limits, to settle claims
Coordinates the litigation activities associated with assigned claims to ensure a timely and cost-effective resolution; attends trials as a representative of the company
Acts as senior technical professional on team, assisting team members with escalated issues
Develops and maintains excellent rapport with our agency force, insureds, claimants, experts, attorneys, and internal customers
Attend mediations, trials, and overnight travel as needed

Qualification

Claims case handlingLiability analysisLitigation managementAdvanced analytical skillsCoverage analysisNegotiation skillsInvestigative skillsVerbal communicationWritten communication

Required

Bachelor's Degree
Demonstrates an advanced knowledge of claims case handling practices, legal liability, general insurance policy coverage, and the state`s tort laws as normally acquired through a bachelor`s degree (or equivalent training) plus 3 to 5 years directly related work experience
Ability to investigate and evaluate complex liability claims
Ability to analyze available information and make effective decisions
Ability to evaluate damages and negotiate fair settlements
Advanced analytical skills
Advanced knowledge of coverage within the team's specialty or focus
Litigation and mediation management experience required
Excellent verbal and written communication skills
Strong background in auto and general liability coverage analysis particularly involving commercial claims with complex issues

Benefits

Competitive compensation plan
Robust benefits package

Company

Berkley Technology Services

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Berkley Technology Services offers networking, software development, UI/UX design, project management and IT shared services.

Funding

Current Stage
Growth Stage

Leadership Team

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Evan Krueger
Software Engineer CoOp
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Jennifer Mignone, SHRM-CP
Senior Human Resources Business Partner
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Company data provided by crunchbase