Auto – GL – Professional Liability Claim Specialist
| Company | CCMSI |
|---|---|
| Location | Altamonte Springs, FL, USA |
| Salary | $76500 – $98500 |
| Type | Full-Time |
| Degrees | Bachelor’s |
| Experience Level | Senior |
Requirements
- 5+ years of ML claim handling experience
- Florida adjuster’s license
- Excellent oral and written communication skills
- Good analytic and negotiation skills
- Ability to cope with job pressures in a constantly changing environment
- Knowledge of all lower level claim position responsibilities
- Detail oriented and a self-starter with strong organizational abilities
- Ability to coordinate and prioritize required
- Flexibility, accuracy, initiative and the ability to work with minimum supervision
- Discretion and confidentiality required
- Reliable, predictable attendance within client service hours for the performance of this position
- Responsive to internal and external client needs
- Ability to clearly communicate verbally and/or in writing both internally and externally
Responsibilities
- Investigate, evaluate and adjust multi-line claims in accordance with established claim handling standards and laws
- Establish reserves and/or provide reserve recommendations within established reserve authority levels
- Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated multi-line claims
- Negotiate any disputed bills or invoices for resolution
- Authorize and make payments of multi-line claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority
- Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate
- Assist in the selection, referral and supervision of designated multi-line claim files sent to outside vendors
- Review and maintain personal diary on claim system
- Assess and monitor subrogation claims for resolution
- Compute disability rates in accordance with state laws
- Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the multi-line claim adjustment process
- Provide notices of qualifying claims to excess/reinsurance carriers
- Compliance with Corporate Claim Handling Standards and special client handling instructions as established
Preferred Qualifications
- Previous experience handling claims in Connecticut, Iowa, Pennsylvania, South Carolina, Tennessee, Virginia, Georgia, Maryland, and Alabama
- Experience with determining liability in cases involving behavioral and mental health issues of facility patients
- Expertise in managing sexual abuse and misconduct liability claims involving facility patients
- Bachelor’s Degree is preferred
- AIC, ARM or CPCU Designation preferred