SUMMARY

Reporting to the Unit Manager, this role will be responsible for direct handling of multi-line commercial claims including Auto, General Liability and Construction Defect claims. Duties include investigation and evaluation of coverage, liability and damages issues. The role will be responsible for claim evaluation, establishment/recommendation of adequate reserves, litigation management, case resolution and transaction processing in alignment with the Company’s and Client’s Strategic Vision.

REQUIRED SKILLS

• Demonstrates ability and flexibility in a dynamic environment.
• Excellent analytical, interpersonal and communications skills, both written and oral.
• Customer service oriented with the ability to develop long-lasting relationships with internal and external business partners.

EXPERIENCE

Minimum of 5 years of claims handling experience or a related field.

REQUIRED EDUCATION

Four-year college degree required or equivalent work experience.

ESSENTIAL FUNCTIONS

• In addition to the essential functions of a Complex Claim Analyst, the Senior Claim Analyst handles more complex cases and/or industry specific cases that include higher exposure with an increase in severity and complexity.
• Mastery of the Complex Claim Analyst functions and Company’s and Client’s systems.
• Anticipates and identifies risks and opportunities on coverage and liability.
• Mentors and guides less experienced claim analysts.
• Assists the Unit Manager with departmental problem solving.
• Manage external relationships including third party administrative oversight.
• Serves on Companywide committees and projects assigned.
• Directly handles and/or assists in monitoring, reviewing, and coordinating the activities involving commercial and personal lines insurance claims, including analysis of coverage issues, establishment of adequate reserves, and the resolution and closure of claims.
• Reviews loss notices; confirms and interprets policy coverage; establishes adequate reserves; and investigates and handles claims involving primary, umbrella and excess policies.
• Manages litigation with Preferred Counsel under Alternative Fee Arrangements or other defense fee structures.
• Pursues and maximizes all risk transfer opportunities by contract or by insurance policy language.
• Assigns and manages work of defense counsel, assignment of expert witnesses and interfacing with peer carriers including design and execution of defense and indemnity contracts, evaluation of liability and damages and participation in settlement negations.
• Ensures proper file setup, reserving, general handling and application of company procedure.
• Participates in developing claims handling strategies, including defense coordination, litigation strategy and budgets, and expense control.
• Records specific claims information and reports as appropriate to a manager relative to pertinent financial and general statistical records.
• Maintains diary control, investigates, analyzes, and reports to ensure maintenance of proper reserves to reflect the company’s exposure and reports to our Reinsurance Department to assist in providing notice to reinsurers and the Reinsurance Department’s recovery of specific amounts when payment exceeds the company’s retention.
• Handles large volume of diverse and dynamic claims effectively.
• Empowered to make decisions within job description and authority. Seeking guidance where appropriate.
• Develop creative ideas and solutions to real-time business problems and /or business opportunities; Takes reasonable, calculated risks even if failure is possible.
• Empowers self and teammates to continuously improve Company’s business processes/systems and develops and escalates ideas and solutions.
• Seeks continuous development by identifying areas for growth and improvement. Works with team to implement process and technical improvements.
• Consistently delivers superior customer service to both internal and external business partners.
• Understands Key Performance Indicators and manages towards those priorities.
• Perform special projects and assignments related to area of authority as necessary.
• Maintains confidentiality.
• Establishes and maintains professional relationships.
• Assists in Due Diligence inquiries as assigned.
• Obtains and maintains claims adjuster licenses in those states requiring them.

SUPERVISORY ROLE

Schedule, assign, and review the work of others in compliance with specific instructions.