Senior Complex Claims Specialist managing high - severity Professional Lines claims from inception to resolution. Collaborating with legal and underwriting teams while providing mentorship to the claims team.
About the role
- 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 claims that includes all phases of litigation
- With minimal supervision, drafts complex coverage letters, including reservation of rights and denial letters
- Reviews and analyses claim documentation and legal filings
- Drives litigation best practices to lead defense strategy on litigated files
- Mentors Claim Examiners
- Uses superior knowledge and experience to affect positive claim outcome via investigation, negotiation and utilization of alternative dispute resolutions
- Identifies emerging exposures and claims trends
- Identifies suspected fraudulent claims and tracks with special investigations unit
- Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities
- Develops content and conducts training for claims team and underwriters as requested
Requirements
- 8+ years of claims handling experience or 7-8 years litigation experience. (A JD from an ABA accredited law school may be considered as a supplement to claims handling experience.)
- Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation
- Advanced knowledge of coverage within the team’s specialty or focus
- Advanced knowledge of litigation process and negotiation skills
- Experience in mentoring and training other claims examiners
- Excellent verbal and written communication skills
- Advanced analytical skills
- B.A./B.S degree from an accredited College or University preferred
Benefits
- 401(k) with competitive company matching
- Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care)
- Company paid group term life, short- term disability and long-term disability coverage
- 24 Paid time off days plus 2 Hiscox days,10 paid holidays plus 1 paid floating holiday, and ability to purchase up to 5 PTO days
- Paid parental leave
- 4-week paid sabbatical after every 5 years of service
- Financial Adoption Assistance and Medical Travel Reimbursement Programs
- Annual reimbursement up to $600 for health club membership or fees associated with any fitness program
- Company paid subscription to Headspace to support employees’ mental health and wellbeing
- Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation
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HS
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