Complex Claims Specialist (Remote)

Selective Insurance; United States; On-site; USD 124,000 - 160,000; Full time

Benefits offered by this job

Health insurance

Paid time off

Retirement plan

Employee stock purchase program

Tuition assistance

Job summary

Selective Insurance is seeking a senior claims specialist to handle the company’s most complex and challenging claims with a focus on coverage analysis, investigation, and disposition. The role requires strategic thinking to manage loss exposures, collaboration with stakeholders, and travel for mediations and trials when needed.

The ideal candidate has extensive casualty claims experience, strong negotiation and communication skills, and a JD preferred along with multi-state licensing.

Qualifications

• Experience in complex coverage analysis and large loss evaluations.
• Superior communication and strategic negotiation and claim disposition skills.
• Excellent presentation skills and proficient with MS Office tools (Outlook, Excel, PowerPoint).
• Must have a valid multi-state driver’s license and be able to drive.

Responsibilities

• Evaluate and resolve coverage issues across all lines of business and liability claim types.
• Investigate claims through telephone, written correspondence, and interviews with claimants, attorneys, insureds, witnesses, etc.
• Effectively manage vendors and expenses.
• Analyze information to determine extent of loss and coordinate medical exams when needed.
• Evaluate, negotiate and resolve claims within delegated authority.
• Provide required reports to claims, underwriting, and reinsurers on significant exposure cases.
• Attend portions of trials when warranted and coordinate with reinsurers as needed.
• Travel up to 20% of time for mediations, arbitrations, and other proceedings.

Skills

Communication skills

Negotiation skills

Problem solving

MS Office

Education

College degree

JD preferred

Tools

Microsoft Outlook

Excel

PowerPoint

Job description

About Us At Selective, we don't just insure uniquely, we employ uniqueness. Selective is a midsized U.S. domestic property and casualty insurance company with a history of strong, consistent financial performance for nearly 100 years. Selective's unique position as both a leading insurance group and an employer of choice is recognized in a wide variety of awards and honors, including listing in Forbes Best Midsize Employers in 2025 and certification as a Great Place to Work® in 2025 for the sixth consecutive year.

Overview

The purpose of this position is to provide direct handling of the company’s most complex and challenging claims. Responsibilities of this position include coverage analysis, investigation, evaluation, negotiation and disposition of assigned claims. Candidate must possess strong litigation management skills to aggressively manage litigation activities, budgets and claim outcomes while considering the overall impact to the customer and company. The individual in this position will also ensure claims are processed within company policies, procedures, and within individual's prescribed authority with exceptional standards of performance. This individual should possess strategic though process skills to effectively and efficiently manage loss exposures. Job duties will include communication and collaboration with key stakeholders, training, development and providing thought leadership where requested. In addition, position may require travel to mediations, arbitrations, settlement conferences, trials or other proceedings which may account for up to 20% of the specialist time. All job duties and responsibilities must be carried out in compliance with applicable legal and regulatory requirements.

Responsibilities

• Effectively evaluate and resolve coverage issues for all lines of business and all liability claim types.
• Investigate the claims through telephone, written correspondence, and/or personal contact with claimants, attorneys, insureds, witnesses and others having pertinent information.
• Effectively and efficiently manage vendors and expenses.
• Timely analyze information in order to evaluate assigned claims to determine the extent of loss, taking into consideration contributory or comparative negligence. Assign medical or other experts to case and arrange for medical examinations when necessary.
• Effectively evaluate, negotiate and resolve claims within delegated authority utilizing the appropriate denials or releases.
• Provide required reports to claims, underwriting, reinsurance and actuarial on significant exposure cases.
• Report on all cases going to trial on a timely basis and attend portions of trials when warranted or where requested by management.
• Ensure proper referrals and timely updates to appropriate Reinsurer(s).
• Ability to handle or oversee responses to time-limited, policy limits demand and threating bad faith or extra contractual exposure against the company.
• Must be able to drive an automobile to travel within territory. Car travel represents approximately 10-25% of employee’s time and a valid driver’s license.
• Travel, including air travel with overnight stays, is about 10% of the job.

Qualifications

Knowledge and Requirements

• Experience in complex coverage analysis and significant large loss evaluations.
• Superior communication and strategic negotiation and claim disposition skills along with proven problem-solving skills.
• Excellent presentation skills and moderate proficiency with standard business-related software (including Microsoft Outlook, Work Excel, and PowerPoint).
• Sufficient keyboarding proficiency to enter data accurately and efficiently.
• Multi-State licensing with strong understanding of Medicare reporting & compliance preferred.
• Must have valid state-issued driver’s license in good standing and be able to drive an automobile.

Education And Experience

• College degree required.
• JD (Law degree) preferred.
• 8+ Casualty claims handling experience (of those, a minimum of 5 years handling cases of a complex nature with a primary P&C carrier).
• Experience with complex commercial GL claims.

Total Rewards

Selective Insurance offers a total rewards package that includes a competitive base salary, incentive plan eligibility at all levels, and a wide array of benefits designed to help you and your family stay healthy, achieve your financial goals, and balance the demands of your work and personal life. These benefits include comprehensive health care plans, retirement savings plan with company match, discounted Employee Stock Purchase Program, tuition assistance and reimbursement programs, and 20 days of paid time off. Additional details about our total rewards package can be found by visiting our benefits page. the actual base salary is based on geographic location, and the range is representative of salaries for this role throughout Selective's footprint. Additional considerations include relevant education, qualifications, experience, skills, performance, and business needs.

Pay Range

USD $124,000.00 - USD $160,000.00 /Yr.

Additional Information

Selective is an Equal Employment Opportunity employer. That means we respect and value every individual’s unique opinions, beliefs, abilities, and perspectives. We are committed to promoting a welcoming culture that celebrates diverse talent, individual identity, different points of view and experiences – and empowers employees to contribute new ideas that support our continued and growing success. Building a highly engaged team is one of our core strategic imperatives, which we believe is enhanced by diversity, equity, and inclusion. We expect and encourage all employees and all of our business partners to embrace, practice, and monitor the attitudes, values, and goals of acceptance; address biases; and foster diversity of viewpoints and opinions. For Massachusetts Applicants It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.