General Liability Claims Specialist

Ohio Farmers Insurance Company; Westfield Center (OH); Remote; USD 60,000 - 100,000; Full time

Job summary

An established industry player is seeking a Claims Specialist to manage complex claims with a focus on coverage analysis and negotiation. This role involves evaluating claims for reserves and settlements, providing exceptional customer service, and collaborating with various teams to enhance processes. The ideal candidate will have extensive experience in claims handling and a strong educational background in business. Join a forward-thinking company that values innovation and excellence in the insurance sector, where your expertise will contribute to delivering superior risk insights and solutions.

Qualifications

• 6+ years of experience in Claims Handling required.
• Bachelor's Degree in Business or related field preferred.

Responsibilities

• Investigates claims thoroughly to determine coverage and liability.
• Collaborates with internal and external partners for claim resolution.

Skills

Claims Handling

Customer Relationship Management

Data Analysis and Reporting

Claims Investigations

Claims Resolution

Education

Bachelor's Degree in Business

Commensurate Work Experience

Tools

Claims Case Management Software

Loss Adjusting Software

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.

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

Behavioral Competencies

• Certified Professional Claims Management (CPCM)


• Certified Claims Adjuster (CCA)


• Adjuster License

Technical Skills

• Business Process Improvement


• Claims Case Management


• Claims Resolution


• Financial Controls


• Claims Settlement


• Claims Adjustment


• Data Analysis and Reporting


• Claims Investigations


• Account Management


• Customer Relationship Management


• Auditing

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.