Senior Corp Claims Specialist - National Environment and Asbestos Experience - Blue Bell, PA

Davita Inc.; Whitpain Township (Montgomery County); Remote; USD 80,000 - 120,000; Full time

Job summary

A leading company in the claims management field seeks a Senior Corporate Claims Specialist. This role demands independent managing of complex claims relating to environmental and asbestos issues across multiple locations. Candidates must possess relevant state licenses and have proven experience in claims management and customer relations, making timely and informed decisions.

Qualifications

• Experience handling GL Environmental and Asbestos claims nationwide required.
• FL and or TX plus NY and CA licenses required.
• Work independently and with minimum supervision.

Responsibilities

• Manage a claims caseload from assignment through resolution.
• Investigate claims to evaluate coverage and legal issues.
• Negotiate settlements and make decisions regarding liability.

Skills

Customer Relations

Negotiation

Legal Interpretation

Claims Management

Job description

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Senior Corp Claims Specialist - National Environment and Asbestos Experience

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Job Description:

With minimal to no supervision, manage a claims caseload from assignment through resolution. Timely, accurately and efficiently assesses claim coverage, liability, legal and damage issues, investigates, evaluates and, through negotiation, mediation, arbitration or litigation, achieves resolution of all assigned claims, including complex claims. Maintains good customer relations, good working relations with co-workers and other company personnel. Substantial independent action is required to resolve complex coverage, factual and legal issues. Keeps claims and jurisdictional knowledge current. Occasional business travel may be needed.

DESCRIPTION OF JOB RESPONSIBILITIES

Timely, accurately and efficiently performs the following job responsibilities, plus any other job responsibilities assigned by her or his manager; timely and accurately advises management on matters relating to her or his job responsibilities:

1. Reviews, analyzes and interprets insurance policy conditions, exclusions and endorsements, to resolve coverage and liability issues for all lines of business;


2. Prepares reservation of rights letters, nonwaiver agreements and coverage disclaimers to address claim coverage issues and partners with coverage counsel as applicable;


3. Timely and appropriately evaluates claim reserves, including periodically evaluating the claim to ensure the respective reserve properly reflects the potential exposure;


4. Prepares case summary reports to management related to matters of significant exposure and reserve;


5. Investigates claims to evaluate coverage and legal issues, including meeting with insureds and witnesses, obtaining insured, claimant and witness statements, medical records, experts, defense counsel and other evidentiary materials and information relevant to the respective claim, plus an overall evaluation of each claim, its potential liability and damages and the company's negotiating posture for settlement purposes;


6. Provides documentation of investigation and claims handling activities;


7. Completes or directs others to complete company reports for claims files;


8. Attends and negotiates through mediations, arbitration, settlement conferences or other court-supervised settlement efforts. Settles and resolves claims with claimants, insureds and their lawyers;


9. Proactively manages the claims to resolution preparing releases, proof of loss and similar documents as evidence of claims resolution and authorizing issuance of settlement funds;


10. Provides direction to and management of defense counsel, independent adjusters and any other third party, including TPAs, retained to assist in a particular claim;

10,. Familiar with reinsurance terms and concepts and communicate with internal staff (management, accounting, etc.)

1. Develops, maintains and enhances good working relations with co-workers and other company personnel with whom contact is necessary to perform her or his job responsibilities;


2. Maintains current knowledge of corporate, claims and jurisdictional environment.


3. Keeps leadership apprised of industry trends that may impact the business;


4. Participate in projects within the organization as required.

#LI-Remote

Requirements:

• Experience handling GL Environmental and Asbestos claims nationwide required


• FL and or TX plus NY and CA licenses required.


• Ability to:

1. Create a work product and achieve results that are highly responsive to servicing our customers' needs and consistent with our company's interest in providing prompt, efficient and effective claims and customer service;


2. Clearly, accurately and effectively communicate, both orally and in written correspondence and both internally and externally, including with our customers, claimants, opposing counsel, defense counsel and members of the public;


3. Develop, maintain and enhance good customer relations with our insureds, agencies and their representatives;


4. Make judgments about complex factual situations, negotiate settlements and make appropriate decisions regarding all lines, including severe bodily injury claims;


5. Timely and accurately recognize and interpret claims issues as they exist or develop and to make appropriate decisions regarding the coverage at issue;


6. Apply, use and interpret applicable state law cases and statutes regarding liability risks, antifraud requirements, insurance issues and tort and contract law principals involving all lines within the assigned territory;


7. Read, comprehend and interpret insurance policy contracts for all lines regarding coverage, liability and insurance issues and apply those insurance policy contracts to factual claim situations;


8. Comply with applicable fair claims practice statutes and other legal requirements;


9. Comply with company procedures;


10. Work independently and with minimum supervision, including occasionally operating in the field;


11. Maintain a high level of quality work product and output;

The above job description is not an exhaustive list of all duties, responsibilities, abilities and job functions associated with this job.