The Claims Adjuster, TPA Oversight will provide technical expertise and handle claims across multiple lines of business, including casualty, property, inland marine, excess/umbrella, and professional liability. Additionally, they will complement the existing Specialty Claims team that supports the Underwriting unit and will provide oversight of third parties and delegated authority referrals across the various lines of business.
Minimum Qualifications:
- Bachelor’s Degree or equivalent work experience.
- 5 + years of claims handling or related experience.
- Licensed Adjuster – Various States.
- Juris Doctor degree preferred.
Primary Job Functions:
- Handle claims originating out of the Specialty Claims unit and provide technical oversight of Third Party Administrators (TPAs).
- Provide coverage, liability, and damages analysis with prompt identification of potential large loss claims.
- Responsible for ensuring adequate reserving and accuracy of claims payments through appropriate supervision and authority levels.
- Work in partnership with the TPA Claims Manager to ensure that claims are proactively managed and that all claim workflows and SLAs are adhered to.
- Ability to proactively identify exposures and claim trends which may affect the portfolio and provide written assessments to the Specialty business unit.
- Resolve problems and respond to coverage questions for underwriting team and senior management.
- Effectively represent the Company’s interests at mediations and settlement conferences.
- Other duties or projects as assigned.
- Some travel required.
The above cited duties and responsibilities describe the general nature and level of work performed by people assigned to the job. They are not intended to be an exhaustive list of all the duties and responsibilities that an incumbent may be expected or asked to perform.
Skills & Competencies Required:
- Ability to analyze complex coverage issues and draft coverage letters.
- Strong interpersonal skills and an ability to establish close working relationship with underwriting, actuarial and legal teams.
- Excellent presentation, verbal and written communication skills.
- Analytical, decision making and resource management skills with an attention to detail.
- Strong commitment to providing superior client service.
- Strong negotiating skills with an ability to identify the strengths and weaknesses of a claim.
Additional Information:
Full benefit package including medical, dental, life, vision, company paid short/long term disability, 401(k), tuition assistance and more.
