Senior Technical Claims Specialist

Brookfield Wealth Solutions, Ltd; Omaha (NE); On-site; USD 90,000 - 150,000; Full time

Benefits offered by this job

Health benefits

Dental benefits

Vision benefits

401(k) match

Paid time off

Professional development

Job summary

Argo Group in Omaha is seeking a Senior Complex Claims Technical Specialist to provide technical support on coverage disputes and major cases. This is a 100% in-office position; you will work on-site five days a week.

You will adjudicate highly complex claims, conduct detailed investigations, set reserves, and coordinate resources, reporting to the SVP, Claims Legal. A JD from an accredited law school and at least seven years of experience are required.

Qualifications

• At least seven years’ experience handling insurance coverage issues and disputes.
• J.D. from an accredited law school.
• Excellent communication skills and the ability to build lasting relationships.
• Licensed Claims Examiner in required jurisdictions; willingness to obtain licenses.
• Ability to travel about 5% of the time.

Responsibilities

• Adjudicate highly complex claims and coverage disputes at high authority limits.
• Conduct detailed information gathering, analysis and investigation.
• Provide technical guidance on setting claim reserves.
• Prepare reports for file documentation.
• Negotiate complex settlement packages within authority.

Skills

Claims adjudication

Customer service

Communication skills

Business acumen

Negotiation skills

Team collaboration

Attention to detail

Problem solving

Education

J.D. from an accredited law school

Tools

MS Office Suite

Job description

Company

Argo Group

Argo Group is an underwriter of specialty insurance products in the property and casualty market. Argo offers a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc.

Job Description

Business Title(s):

Senior Complex Claims Technical Specialist

Employment Type:

Full-Time

FLSA Status:

Exempt

Location:

In Office - Any employee, in any Clearbrook office, can apply for this opportunity and stay in their current location.

Summary:

We are looking for a highly capable Senior Complex Claims Technical Specialist to join our team and work in our Omaha office. We work together in the office five days a week in order to strengthen our culture, build team connections, and drive profitability. This role will directly report to the SVP, Claims Legal based in Chicago and is responsible for providing technical support on insurance coverage disputes and major cases in litigation assigned to Adjusters throughout the US.

This is a 100% in-office position. Candidates must be able to work on-site at a designated company office during standard business hours.

Essential Responsibilities:

• Working with limited oversight under broad management direction, adjudicate highly complex claims and insurance coverage disputes mostly for our casualty line of business, at the highest authority limits on assignments reflecting the highest degree of technical complexity and coordination in liability and litigated claims, potentially with major impact on departmental results.
• Conducting detailed information gathering, analysis and investigation to find solutions to issues that are numerous and undefined.
• Oversee defense panelist, including monitoring and evaluating operations and performance.
• Conduct file reviews to ensure accuracy, attend mediations and settlements, and participate in pre-trail calls as necessary.
• Provide technical guidance in properly setting claim reserves.
• Reporting to senior management and underwriters on insurance coverage issues and claims trends and developments.
• Investigating insurance coverage issues and claims promptly and thoroughly
• Analyzing claims forms, policies and endorsements, client instructions, and other records to determine whether the loss falls within the policy coverage.
• Investigating claims promptly and thoroughly, including interviewing all involved parties.
• Managing claims in litigation
• Managing diary timely and complete tasks to ensure that cases move to the best financial outcome and timely resolution.
• Properly setting claim reserves, taking into account how different policy wordings impact the claims reserving process.
• Identifying, assigning, and coordinating the assignment and coordination of expertise resources to assist in case resolution.
• Preparing reports for file documentation
• Applying creative solutions which result in the best financial outcome.
• Negotiates highly complex settlement packages, sets reserves and authorizes payment within scope of authority, settling claims in most cost effective manner and ensuring timely issuance of disbursements.
• Processing mail and prioritizing workload.
• Completing telephone calls and written correspondence to/from various parties (insured, claimant, etc.).
• Having an appreciation and passion for strong claim management.
  

Qualifications / Experience Required:

• A deep knowledge of claims adjudication and focus on customer service typically achieved through:
  • At least seven years’ experience handling insurance coverage issues and disputes, with exposure of $100,000 or more, for Commercial General Liability (including Bodily Injury and Property Damage, Construction Defect, New York Labor Law, Garage, Inland Marine, Excess, Property, and Environmental.
  • A J.D. from an accredited law school
• Must have good business acumen (i.e. understand how an insurance company works and makes money, including how this role impacts both Argo Group and our customers’ ability to be profitable).
• Ability to regularly exercise discretion and independent judgment with respect to matters of significance.This role primarily faces problems and issues that are difficult and require an understanding of a broader set of issues.
• Must have excellent communication skills and the ability to build lasting relationships.
• Exhibit natural curiosity in order to consistently explore and consider all options and is not governed by conventional thinking.
• A strong focus on execution in getting things done right. Proven ability to consistently produce and deliver expected results to all stakeholders by:
  • Finding a way to achieve success through adversity.
  • Being solution (not problem) focused
  • Thinking with a global mindset first.
• Successful traits (flexibility, ability to thrive in change, being resourceful on your own) necessary to work in a fast paced environment that is evolving constantly.
• Excellent evaluation and strategic skills required.
• Strong claim negotiation skills a must.
• Knows how claims reserving techniques are used and how to assess whether a claim reserve is accurate.
• Must possess a strong customer focus.
• Effective time management skills and ability to prioritize workload while handling multiple tasks and deadlines.
• Demonstrates innovative thinking and regularly shares ideas to help the team whenever possible
• Ability to articulate the financial value of your work at multiple responsibility levels inside our clients’ business which may include CEO.
• Demonstrates inner strength. Has the courage to do the right thing and demonstrates it on a daily basis.
• Proficient in MS Office Suite and other business-related software.
• Polished and professional written and verbal communication skills in order to present information accurately and effectively.
• The ability to read and write English fluently is required.
• Must demonstrate a desire for continued professional development through continuing education and self-development opportunities.
• Licensed Claims Examiner (Based on state) Must possess or be willing to quickly obtain a license in each jurisdiction requiring a license to adjudicate first party claims within 120 Days.
• Ability to travel about 5% of the time (average one day per month), sometimes overnight.
  

About Working in Claims at Argo Group

• Argo Group does not treat our claims or our claims professionals as a commodity. The work we offer is challenging, diverse, and impactful.
• Our Adjusters and Managers are empowered to exercise their independent discretion and, within broad limits and authority, be creative in developing solutions and treat each case as the unique situation it is.
• We have a very flat organizational structure, enabling our employees have more interaction with our senior management team, especially when it relates to reviewing large losses.
• Our entire claims team works in a collaborative nature to expeditiously resolve claims. We offer a work environment that inspires innovation and is open to employee suggestions. We even offer rewards for creative and innovative ideas.
• We believe in building an inclusive and diverse team, and we strive to make our office a welcoming space for everyone. We encourage talented people from all backgrounds to apply.

PLEASE NOTE:

Applicants must be legally authorized to work in the United States. At this time, we are not able to sponsor or assume sponsorship of employment visas.

If you have a disability under the Americans with Disabilities Act or similar state or local law and you wish to discuss potential reasonable accommodations related to applying for employment with us, please contact our Benefits Department at 210-321-8400.

Benefits and Compensation

We offer a competitive compensation package, performance-based incentives, and a comprehensive benefits program—including health, dental, vision, 401(k) with company match, paid time off, and professional development opportunities.

Core Values

At Clearbrook our Core Values are Integrity, Collaboration, Pursuit of Excellence and Forward Thinking. These values reflect who we are today and who we aspire to be - guiding how we work, how we lead and how we succeed.