STD Claims Examiner II making accurate claim decisions for Short Term Disability claims. Collaborating with team members in a hybrid work environment from South Portland, ME.
About the role
- Senior Claims Specialist at Everest Insurance managing complex Professional Liability claims across various industries. Analyzing coverage issues and directing outside counsel in a hybrid work setting.
Responsibilities
- Reviewing and analyzing complex coverage issues and preparing coverage positions letters
- Investigating, analyzing, and evaluating liability and damages
- Managing and directing outside counsel; reviewing & approving legal budgets and fee statements
- Preparing Large Claim Reports related to matters of significant reserve and trial activity
- Timely and appropriately setting case reserves
- Developing and executing negotiation and resolution strategies
- Monitoring and attending trials, mediations and settlement conferences
- Engaging with underwriting supporting policy construction and drafting, reporting claim trends, data analysis and risk assessment
- Extensive communications with insureds, brokers, reinsurers and other business contacts
- Attending client meetings and industry functions to support retention and development of client relationships and business.
Requirements
- 3-5 years of Professional Liability claims experience
- Strong oral and written communication skills
- Strong analytical and organizational skills
- Strong negotiation and investigation skills
- Excellent interpersonal skills
- Ability to evaluate coverage involving a wide variety of loss scenarios and ability to think strategically
- In-depth knowledge of the litigation, arbitration, and trial process
- Currently holds or can readily obtain all required adjuster licenses
- Knowledge of insurance industry, claims and the insurance legal and regulatory environment
- Ability to identify and use relevant data and metrics to best manage claims
- Collaborative mind-set and willingness to work with people outside immediate reporting hierarchy to improve processes and generate optimal department efficiency
- Ability to and willingness to present to senior management and other stakeholders
- Ability to resolve complex disputed claims
- J.D. (currently licensed) / experience practicing law preferred
Benefits
- health insurance coverage
- an employee wellness program
- life and disability insurance
- 401k match
- retirement savings plan
- paid holidays
- paid time off (PTO)
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