Claims Specialist
E
ERGO NEXTSmall business insurance
RemoteFull-TimeSenior
Salary100,000 - 130,000 USD per year
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Job Details
- Experience
- 10+ years
- Required Skills
- Negotiation
Requirements
- BS/BA Degree required.
- 10+ years of directly related experience with Commercial General Liability and Litigation.
- In-depth knowledge of multi-jurisdictional claims handling issues.
- Strong written and oral communication, negotiation, and analytical skills.
- Texas Independent Adjuster License (or ability to promptly obtain one).
- Proficiency in insurance contracts, legal codes, and claims best practices.
- Experience in litigation handling for General Liability and Casualty files.
- Ability to adapt to evolving proprietary and off-the-shelf software systems.
- Capability to travel up to 10% of the time.
Responsibilities
- Handle high-severity and high-complexity claims.
- Interpret complex policy documents and legal contracts.
- Manage, investigate, and resolve claims within prescribed authority levels.
- Drive litigation and attend mediations, trials, and other alternative dispute resolution avenues.
- Present file materials for authority and lead department roundtables.
- Collaborate with nurses, doctors, attorneys, and internal leadership regarding claim activities.
- Provide claim-specific guidance to independent field adjusters.
- Identify potentially suspicious claims and third-party subrogation opportunities.
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