Specialty Risk/Non-Standard Claim Resolution Specialist

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Requirements:

• Bachelor's degree (not mandatory if all other qualifications are met).
• Minimum of 3 years of general claims experience.
• Active adjuster license(s) and willingness to obtain additional licenses within 60 days.
• Knowledge of state regulations, policy provisions, and standard operating procedures.
• Ability to analyze complex data and make sound decisions based on established guidelines.
• Curious and motivated by problem-solving.
• Desire for continuous professional development.
• Willingness to travel for client and claims needs.
• Excellent verbal and written communication skills.
• Strong attention to detail and superior organizational skills.
• Working knowledge of personal computers, including Google Docs and Sheets.

Responsibilities:

• Provide prompt, courteous and high-quality customer service to all policyholders and claimants.
• Gather necessary information from customers to initiate claims and explain policies and coverage.
• Manage an inventory of claims and establish initial reserves for all potential exposures.
• Ensure compliance with state regulations, policy provisions, and standard operating procedures.
• Communicate with involved parties and process appropriate settlements within the approved payment authority.
• Provide input for continuous development of claims guidelines and process improvements.
• Oversee outside investigative services to help resolve claims.
• Engage in learning opportunities to build knowledge of personal lines claims.