Claims Specialist (Remote)

RecruiterForge; United States; On-site; USD 100,000 - 400,000; Full time

Benefits offered by this job

Comprehensive health care plans

401(k) with company match

Employee stock purchase plan

Tuition assistance and reimbursement

Job summary

RecruiterForge is seeking an experienced casualty claims professional to handle complex E&S matters, including coverage analysis, investigation, and loss evaluation. The role requires managing litigation and budgets, with decisions within delegated authority up to $400,000, while coordinating with claimants, attorneys, insureds, and vendors.

The ideal candidate has extensive casualty claims experience, strong negotiation and communication skills, and proficiency with Microsoft Office.

Qualifications

• 8+ years of casualty claims handling experience.
• Experience with complex coverage analysis and large losses.
• Ability to write coverage letters and manage litigation.

Responsibilities

• Evaluate and resolve coverage issues across lines of business and liability types.
• Investigate claims via phone, written correspondence, and direct contact with claimants, attorneys, insureds, witnesses, and other parties.
• Manage litigation, vendors, and expenses to support effective claim resolution.
• Analyze losses and engage experts when needed; arrange medical examinations when appropriate.
• Negotiate and resolve claims within delegated authority ($100,000–$400,000).
• Prepare reports on exposures for claims, underwriting, reinsurance, and actuarial teams.
• Provide timely updates and referrals to reinsurers; support training and guidance.

Skills

Casualty claims handling

Complex coverage analysis

Litigation management

Negotiation

Communication skills

Microsoft Office

Tools

Microsoft Outlook

Word

Excel

PowerPoint

Job description

Handle complex excess and surplus lines (E&S) claims, including coverage analysis, investigation, loss evaluation, negotiation, and resolution. Manage litigation activities, budgets, and claim outcomes while following company procedures, delegated authority, and applicable legal and regulatory requirements.

Claims and litigation responsibilities

• Evaluate and resolve coverage issues across lines of business and liability claim types.
• Investigate claims through telephone calls, written correspondence, and direct contact with claimants, attorneys, insureds, witnesses, and other relevant parties.
• Manage litigation, vendors, and expenses to support effective claim resolution.
• Analyze losses, including contributory or comparative negligence, and engage medical or other experts when needed.
• Arrange medical examinations when appropriate.
• Evaluate, negotiate, and resolve claims within delegated authority ranging from $100,000 to $400,000, using appropriate denials or releases.
• Prepare reports on significant exposures for claims, underwriting, reinsurance, and actuarial teams.
• Report promptly on cases proceeding to trial and attend portions of trials when warranted or requested.
• Make appropriate referrals to reinsurers and provide timely updates.
• Collaborate with stakeholders and contribute to training, development, and technical guidance as requested.

Experience and qualifications

• At least 8 years of casualty claims handling experience.
• At least 5 years handling complex cases with a primary property and casualty carrier.
• Experience with complex coverage analysis and significant large-loss evaluations.
• Ability to write coverage letters.
• Strong litigation management, communication, strategic negotiation, claim resolution, and problem-solving skills.
• Excellent presentation skills and moderate proficiency with standard business software, including Microsoft Outlook, Word, Excel, and PowerPoint.
• Ability to enter data accurately and efficiently.
• Valid state-issued driver's license in good standing and ability to drive an automobile.

Preferred qualifications

• Multi-state licensing and a strong understanding of Medicare reporting and compliance.
• New York Labor Law experience.
• Experience with habitability, assault and battery, and Coverage B claims.

Compensation and benefits

• Base salary depends on geographic location, education, qualifications, experience, skills, performance, and business needs.
• Comprehensive health care plans.
• Retirement savings plan with company match.
• Discounted employee stock purchase program.
• Tuition assistance and reimbursement programs.