General Liability Claims Specialist

Davita Inc.; Westfield Center (OH); Remote; USD 70,000 - 90,000; Full time

Job summary

A leading company is seeking a Claims Specialist responsible for managing complex claim assignments, from coverage analysis to negotiation of settlements. This remote role requires significant experience in claims handling, customer service, and the ability to collaborate effectively with various stakeholders to achieve best outcomes.

Qualifications

• 6+ years of Claims Handling experience required.
• Bachelor's Degree in Business or related field.
• For field roles: Valid driver's license needed.

Responsibilities

• Determines coverage and investigates claims thoroughly.
• Evaluates damages and establishes reserves for claims.
• Collaborates with other professionals in claims handling.

Skills

Claims Investigations

Claims Resolution

Customer Relationship Management

Data Analysis and Reporting

Education

Bachelor's Degree in Business or related field

Job description

Job Summary

The Claims Specialist works on highly complex claim assignments requiring specialized knowledge. The role handles activities including, but not limited to, coverage analysis, liability and damage investigation, litigation, and expense management. The role also evaluates claims for reserve and settlement, executes settlement strategy, negotiates settlements proactively, attends arbitrations and ensures appropriate file documentation. Westfield Casualty Claims resolves third party liability claims involving injury, property damage, construction defect, personal & advertising injury, and environmental cleanup - both pre-suit and in litigation.

Job Responsibilities

• Determines whether proper coverage exists for the type of claim assigned, investigates thoroughly to obtain relevant facts concerning coverage, liability, legal climate, potential exposure, and damages, and makes decisions on claim resolution.
• Determines the value of damage through physical inspections, uses appropriate tools, reviews policy coverages, inspects damages, determines cause and origin, investigates questionable circumstances, and considers subrogation and salvage possibilities.
• Establishes and reviews proper reserves for each claim based upon thorough investigation, evaluation, and experience.
• Completes appropriate reports so that the current status of the claim is clearly documented at all times.
• Assists claims professionals in the handling of large or complicated property losses.
• Participates in the coaching, development, training and education of claims professionals.
• Collaborates with property leadership team in the identification of property training needs.
• Assists in the design, development, and delivery of training to claims professionals.
• Provides outstanding customer service, works well with the insured and broker in the adjustment of mainstream risks, and claims.
• Collaborates in the defense and resolution of claims, reviews and analyzes contracts for risk transfer potential.
• Documents relevant events timely as case facts are developed, evaluates liability, damages, and exposure, negotiates timely settlements and refers claims exceeding authority to appropriate leader or complex claims specialist with recommendations.
• Provides general administrative, clerical and customer service assistance on the routine tasks to the Claims Adjustment team.
• Collaborates with internal and external business partners, large account customers, peers and other departments to make decisions that are in the best interest of the company.
• Remains current on industry topics, trends, processes, technology, best practices through research, industry events, networking, etc.
• Shares knowledge gained with others, drives new and updated policies, processes, and procedures.
• Supports and reports on the claims process improvement program, including the coordination and participation in best practice creation, monthly metric analysis etc.
• Supports catastrophe management efforts, organizes, deploys personnel, trains independent contractors, utilizes loss adjusting software and supports business partners by maintaining and enhancing relationships with customers and brokers.
• Travels as often as needed to cover assigned territory.
• This may involve traveling on short notice or other daily driving duties as assigned.

Job Qualifications

• 6+ years of Claims Handling experience.
• Bachelor's Degree in Business or a related field and/or commensurate work experience.
• For field roles only: Valid driver's license and a driving record that conforms to company standards.

Location

Remote

Licenses and Certifications

• Certified Professional Claims Management (CPCM) (preferred)
• Certified Claims Adjuster (CCA) (preferred)
• Chartered Property Casualty Underwriter (CPCU) (preferred)

Behavioral Competencies

• Collaborates
• Communicates Effectively
• Customer Focus
• Decision Quality
• Nimble Learning

Technical Skills

• Account Management
• Claims Investigations
• Claims Adjustment
• Claims Resolution
• Claims Settlement
• Financial Controls
• Auditing
• Claims Case Management
• Customer Relationship Management
• Business Process Improvement
• Auditing
• Data Analysis and Reporting

This job description describes the general nature and level of work performed in this role. It is not intended to be an exhaustive list of all duties, skills, responsibilities, knowledge, etc. These may be subject to change and additional functions may be assigned as needed by management.

Founded in 1848, Westfield is a global leader in property and casualty insurance, delivering superior risk insights and innovative solutions to customers through a diverse portfolio of insurance products. Westfield underwrites commercial, personal, surety, and specialty lines of coverage through a network of leading independent agents and brokers in the United States and specialty products through Lloyd's of London Syndicate 1200. As a mutual insurance company with more than 3,000 employees, Westfield has revenues in excess of $4 billion and more than $10 billion in assets.