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("Claims Technical Specialist" OR "Senior Claims Specialist" OR "Claims Examiner" OR "Professional Liability Claims Specialist" OR "Claims Consultant")
E&O OR D&O OR EPLI

Summary

Job Title - Claims Technical Specialist
Location: (Remote)
Duration - 12+ Months

Work Arrangement: Hybrid

The Opportunity: The purpose of this role is to oversee the examination, evaluation, and processing of complex claims estimates and paid claims values, ensuring adherence to policy terms and conditions in alignment with the client claims philosophy. The role also entails supporting the claims function in specific insurance classes to drive operational efficiency, efficient claims settlement, and fair resolution of claims disputes in line with company guidelines and philosophy. The selected candidate will manage the complete investigation, evaluation, and resolution of the assigned portfolio of complex claims emanating from the lawyers' professional and miscellaneous professional liability business segments. Engages, directs, and manages external advisors and vendors, including legal service professionals, discovery vendors, data and security experts, and consultants across a highly complex portfolio of matters.

Your new role:

Manage a diverse portfolio of complex claims, which includes conducting fact, liability and loss investigations and interpreting insurance contracts in an effective and efficient manner
Evaluate and negotiate the resolution of assigned claims in a timely manner, within appropriate authority and in accordance with applicable laws, regulations, statutes, best practices and Department of Insurance (DOI) compliance
Drive the highest level of customer care, responsiveness, and satisfaction when managing assigned claims to deliver superior claim outcomes
Collaborate with outside representative counsel to formulate litigation strategy, ensuring achievement of desired outcome and effective litigation management strategies
Directs and manages external advisors and vendors, including legal service professionals, discovery vendors, data and security experts, and consultants.
Oversee projects and planning surrounding departmental initiatives to achieve strategic objectives
Analyze, develop and determine appropriate case reserves on all assigned claim files and recommend changes where necessary to ensure actuarial accuracy
Advise on specific professional liability areas of specialization and coordinates efforts to disseminate information and guide learning and thought leadership in those areas; serve as the subject matter expert
Represent the client by participating in and attending industry seminars or authoring articles pertaining to professional liability subjects
Collaborate with Underwriters to identify, understand and address Client or complex risks to appropriately price and negotiate terms, including participation in sales calls and requests for proposals (RFPs)
Manage relationships with external vendors to deliver accurate, timely, and cost-effective solutions.
Take ownership for personal development and career planning and the development of required skills, tools, techniques, and technology to continually add value to the organization.
Manage budgeted resources by anticipating expenditures, accurately forecasting resource needs/costs and properly accounting for expenses to meet requirements and achieve fiscal responsibility

Required Education: Bachelor's Degree or equivalent combination of education and work experience
Preferred Education: Juris Doctor

Required Experience:

8 years relevant experience
Generate original, innovative solutions to difficult or unusual situations
Identify and locate information and facts which are necessary and relevant for the purposes of evaluating a claim
Financial and business acumen and awareness of financial responsibility
Quickly change direction when working on multiple projects or issues
Properly document investigation findings and preserve evidence in accordance with internal and external laws and procedures
Use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems
Assume a methodical approach to a given situation and develop a systematic procedure as a response
Develop effective negotiation strategies and prepare a plan of action
Build and capitalize on beneficial internal and external relationships, including competitors
Actively contributes towards continuously improving performance and mentor team with feedback, on-the-job skill enhancement opportunities and career advice
Build and establish constructive and cooperative working relationships and open lines of communication
Utilize effective communication skills to influence and persuade decision makers
Manage a diverse and extensive portfolio of management and professional liability claims with varying levels of complexity and activity.
Collaborate with internal resources to resolve difficult claims situations and drive resolution opportunities with internal and external stakeholders

Thanks And Regards,

Amit Lakhotia

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

Dice Id: SANS3
Position Id: 9038478
Posted 4 days ago

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Amit Lakhotia

Technical Recruiter @ SANS

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Claims Technical Specialist

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Amit Lakhotia

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