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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
- Directly handle, manage, and/or oversee a diverse portfolio of Inland claims, including Builders Risk, Contractors Equipment, Motor Truck Cargo, Warehouse Legal Liability, Installation Floaters, and other related inland marine lines.
- Directly handle, manage, and/or oversee first-party E&S quota-share property claims and middle market property claims.
- Handle all claims in accordance with Claim Handling Best Practices, including initial contact, thorough investigation, coverage analysis, exposure evaluation, reserving, settlement, and complete file documentation.
- Deliver exceptional customer service in all interactions with insureds, brokers, claimants, internal colleagues, and external business partners.
- Conduct detailed policy reviews to determine coverage, limitations, exclusions, and applicable endorsements.
- Resolve all coverage matters, collaborating with coverage counsel when appropriate.
- Prepare highquality written reports and communicate claim developments to management, underwriting, actuarial staff, and reinsurers as needed.
- Adhere to all statutory regulations, statespecific adjusting requirements, and Unfair Claims Settlement Practices Acts.
- Provide regular communication on claim strategy, liability and damage evaluation, and authority requests to claims leadership.
- Participate in mediations, settlement conferences, inspections, site visits, and other claimresolution activities.
- Work closely with underwriting and other business partners to analyze claim trends, provide feedback on loss drivers, and assist in evaluating or refining policy wording.
- Attend meetings with insureds, brokers, and program partners alongside underwriting, as needed.
- Engage and manage outside vendors, including field adjusters, forensic accountants, engineers, restoration firms, and outside counsel, ensuring budget oversight and strategic direction.
Support continuous improvement initiatives within the claims organization and contribute to team knowledgesharing 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.
Licenses and Certifications
- Minimum 6+ of Inland Marine and firstparty claimhandling experience with a specialty carrier, TPA, or equivalent environment.
- Strong background handling Builders Risk, Contractors Equipment, Cargo, Warehouse Legal Liability, and related inland marine coverages.
- Experience handling firstparty commercial property claims (in addition to inland marine).
- Bachelor's degree required; advanced industry designations (AIC, CPCU, AMIM, SCLA) preferred.
- Ability to obtain and maintain required state adjuster licenses.
- Excellent written and verbal communication skills, including the ability to clearly convey complex technical concepts to insureds, brokers, and internal leadership.
- Strong analytical, investigative, negotiation, and problemsolving abilities.
- Demonstrated ability to manage a highvolume, fastpaced workload, prioritize effectively, and operate with limited supervision.
- Proficiency in Microsoft Outlook, Windows, Excel, and common claimsmanagement systems.
- Ability and willingness to travel as needed for inspections, mediations, and site meetings.
- Ability to work onsite 4 days per week in accordance with corporate policy.
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. #WSP
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