Casualty Claim Representative Ii Wfh (Remote)

Overview

We invite you to join our distinguished team as a Technical Claims Specialist. In this pivotal role, you will manage a specialized portfolio of technical claims, overseeing files that encompass various types of coverage and associated complexities. This position may occasionally entail navigating substantial coverage matters and litigation scenarios. We are seeking an individual with established proficiency in managing bodily injury claims, particularly those involving comparative negligence theories and defenses. Your primary objective will be to resolve claims efficiently and fairly, adhering to policy provisions and legal standards.

Key Responsibilities

• Conduct thorough investigations into losses associated with designated claims.
• Negotiate settlements within prescribed limits or defined authority.
• Assume full responsibility for all assigned claims until a resolution is achieved.
• Advise on further steps for claims surpassing authority thresholds.
• Document all significant actions on assigned claims and assist in coordinating with independent vendors.
• Evaluate new losses and open files to ensure adequate reserves, consistently updating management on adverse developments.
• Monitor and manage loss adjustment expenses effectively.
• Utilize vendors wisely to maximize added value.
• Address coverage inquiries and collaborate with supervisors and claims management for approvals.
• Ensure meticulous handling, documentation, reporting, and expense management in claim files.
• Provide timely, accurate, and professional information regarding claim statuses to both external and internal stakeholders.
• Participate in meetings with policyholders and agencies as required.
• Act as a technical resource within the department through mentoring and knowledge exchange.
• Draft coverage-related correspondence and detailed communications for insured individuals, claimants, attorneys, and others.
• Attend trials, depositions, EUOs, appraisals, and mediations as necessary.
• Enhance departmental processes to improve service levels for both internal and external clients.
• Assist in determining file direction and recommend appropriate reserves on claims.
• Conduct technical training sessions for agents, colleagues, and support staff.
• Manage assigned claims and undertake various duties or special projects as needed.

Qualifications

• A bachelor’s degree in business, insurance, or a related field, or equivalent experience.
• A minimum of three years of relevant technical claims experience, or a combination of education and experience.
• Possession of appropriate state adjuster’s license(s) as required by law, including CT, RI, VT, NH.
• Previous field-based experience preferred for positions involving external travel, alongside a valid driver’s license.
• Comprehensive understanding of the technical facets of property and/or casualty claims.
• Proven commitment to ongoing professional development through continuing education.
• Expertise in specialized technical disciplines, including insurance, contract, and tort law.
• Strong analytical and negotiation capabilities.
• Exceptional verbal and written communication skills.
• Ability to exercise sound judgment in various professional scenarios.
• Effective collaboration skills with peers, management, and external partners.
• Strong customer service orientation.
• Proficiency in PC applications, including Microsoft Office Suite (Word, Excel, and Outlook); experience with imaging programs is advantageous.
• Capability to perform under pressure in stressful situations.

Career Growth Opportunities

This position offers significant opportunities for professional advancement, including participation in technical training and continuous education in specialized areas such as insurance and contract law. You will have the chance to contribute to process enhancements that elevate service quality.

Company Culture And Values

We pride ourselves on fostering a collaborative and supportive work environment, encouraging team members to share knowledge and mentor one another. Our company culture is rooted in a commitment to excellence and the continuous professional development of our employees.

Networking And Professional Opportunities

Joining our team grants you access to a vast professional network, offering ample opportunities for skill development and collaboration within the industry.

Employment Type: Full-Time