Complex Claims Consultant - Accountants

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Complex Claims Consultant - Accountants
The candidate manages an inventory of highly complex specialty claims with large exposures that require a high degree of specialized technical expertise and coordination. Ensures exceptional customer service to internal and external business partners by managing all aspects of the claim, interacting professionally and effectively, achieving quality and cycle time standards, providing timely updates, and responding promptly to inquiries and requests for information. Verifies coverage by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters. Establishes timely and adequate reserves, including estimating potential claim valuation, while following company's claim handling guidelines. Manages all types of investigative activity and/or litigation on major claims. Coordinates discovery and litigation strategy with counsel. Determines if a claim should be settled or litigated and implements an appropriate resolution strategy accordingly. Effectively manages loss and claim expenses. Negotiates highly complex settlement packages within authority, settling claims in the most cost effective manner and ensures timely issuance of disbursements. Establishes and manages claim budgets by achieving timely claim resolution, selecting and actively overseeing appropriate resources, authorizing expense payments and delivering high quality service in an efficient manner. Keeps senior leadership informed of significant risks and losses by completing loss summaries, identifying claims to include on oversight/watch lists, and preparing and presenting succinct summaries and recommendations to management. Maintains subject matter expertise and keeps current on state/territory regulations and issues, industry activity, and trends. Inputs of data and file documentation that accurately reflects claim circumstances and other information important to the business outcomes. Mentors, guides, develops, and delivers training to less experienced Claim Professionals. May perform additional duties as assigned. Bachelor's degree or equivalent experience is required. Juris Doctorate is strongly preferred. Should have 8+ years claims experience.

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