Senior Claims Specialist – Design Professional

Senior Claims Specialist – Design Professional

Requirements

• 5-10+ years of claims management experience in Casualty and/or Specialty Lines Claims
• Demonstrated leadership, organizational, and management skills or experience practicing law as well as claims management (both directly managed and TPA managed claims)
• Demonstrated ability to influence and collaborate at all organizational levels, both internally and externally as well as the ability to identify and resolve complex, disputed claims
• Analytical thinker that can drive results using all facets of the legal and claims processes
• Understanding of and ability to balance both the immediate claim issues as well as the broader portfolio impact and customer service impact of coverage disputes and issues
• Excellent oral and written communication skills with the ability to deal effectively with people with conflicting expectations, differing opinions, and multiple viewpoints
• Demonstrated ability and experience handling casualty claims involving a wide variety of loss scenarios as well as reporting and presenting about same to senior management
• In-depth knowledge of claims, litigation, arbitration, and trial processes as well as excellent analytical, investigative, and negotiating skills
• Bachelor’s degree required. JD a plus.
• Valid licenses by state as required and add states to certifications as needed

Responsibilities

• Direct management of claims including the investigation, analysis and evaluation of coverage liability and damages, within best practices of third-party, rectification and sub-gap claims
• Reviewing claims to determine nature of loss, coverage provided, and scope of claim and to guide strategic direction regarding settlement/disposition of claims
• Developing and maintaining relationships with internal and external partners as their lead contact within the claims department for assigned claims and the claims of his/her direct reports
• Close collaboration with the Specialty Complex Claims team with regard to coverage disputes, including litigation and arbitration matters initiated by Axis issuing companies and when Axis issuing companies are parties to such litigation; Collaborating across disciplines and business units, including: the general counsel team overseeing errors and omissions issues arising from claims handling
• Escalating coverage issues and recommending outside coverage counsel assignments for approval where warranted
• Formulating claims and litigation strategies, assigning, directing, and managing outside counsel
• Managing costs, including use of coverage counsel and litigation costs as well as collaborating and working with the Litigation Management and Vendor Management teams ensuring cost management and the development and enhancement of the vendor panels
• Fostering relationships and communicating extensively with senior executives, brokers, reinsurers, actuaries, underwriters, insureds, and auditors (both external and internal)
• Supporting underwriting inquiries and information requests regarding policy construction and drafting, reporting claim trends, data analysis, and risk assessments
• Maintaining documentation of key line of business statistics and metrics
• Leading and participating in presentations and discussions with Underwriters and Insureds on large losses and claim trends
• Leading and participating in claim audits, audit wrap up meetings, and formal result reporting
• Identifying, liability and coverage trends and issues with both individual and portfolio impact and formulating the processes and strategies for handling such claims as well as ensuring accurate and consistent claims management across impacted underwriting segments and lines of business
• Other duties as assigned

Preferred Qualifications

• Technical knowledge, skills, and training within the field to include: Complex coverage analysis and experience required
• Confidence in coverage, evaluation and reserving
• Excellent writing and editing skills
• Solid negotiation and settlement skills
• Supervisory perspective, with experience providing direction and authority to adjusters
• Familiarity with KPI, Data, and Metrics a plus