Complex Claims Specialist Mpl

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Complex Claims Specialist – MPL
The candidate will adjusts and resolves complex to severe claims that includes all phases of litigation. With minimal supervision, drafts complex coverage letters, including reservation of rights and denial letters. Reviews and analyses claim documentation and legal filings. Drives litigation best practices to lead defense strategy on litigated files. Mentors Claim Examiners and Associate Claim Examiners. Uses superior knowledge and experience to affect positive claim outcome via investigation, negotiation and utilization of alternative dispute resolutions. Identifies emerging exposures and claims trends. Identifies suspected fraudulent claims and tracks with special investigations unit. Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities. Develops content and conducts training for claims team and underwriters as requested. Must have 8+ years of claims handling experience. A JD from an ABA accredited law school may be considered as a supplement to claims handling experience. Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation Advanced knowledge of coverage within the team’s specialty or focus. Advanced knowledge of litigation process and negotiation skills. Experience in mentoring and training other claims examiners. Excellent verbal and written communication skills. Advanced analytical skills. B.A./B.S degree from an accredited College or University preferred. Ability to act a subject matter expert within team. Demonstrated ability to work with minimal oversight. Experience attending and leading mediations, arbitrations and trials. Demonstrated ability to advance product innovation or develop a greater understanding of other aspects of the business through training or other relevant projects. Demonstrates courage in addressing and solving difficult or complex matters with insureds, attorneys and brokers. Demonstrated steps taken toward additional certifications by an approved authority such as a CPCU, ARMS or AINS designation.

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