Claims Service Specialist III - Commercial Lines BI Team

Arbella•Quincy, MA

46d

About The Position

Under limited supervision, this role investigates and resolves first and third party material damage, WC, PIP, BI, GL and Property claims. The position may focus on intermediate exposure, Commercial Auto, Homeowner liability, and/or Commercial Property claims, with stretch assignments based on experience. The Claims Service Specialist III will provide guidance and direction to legal counsel during the litigation process to ensure favorable resolution and act as a mentor to new employees. Key Responsibilities include timely completion of all case activities, maximizing customer service and minimizing net loss payout. This involves contacting insureds, claimants, and witnesses, potentially visiting accident locations to examine, photograph, and diagram physical facts, and conducting neighborhood canvasses. The role requires inputting and retrieving information using the automated claims system, requesting checks, form letters, and other correspondence. It also involves evaluating case facts to determine coverage, liability, and reserves, and reporting on settlements. The specialist will interpret and evaluate medical reports, monitor legal and medical billings, and investigate for proper charges. Negotiation of settlements with individuals, attorneys, and other insurance carriers within granted authority is a key function, as is pursuing subrogation and arranging for salvage to obtain maximum recovery. Preparation of detailed scope of damages on property losses and bringing them to conclusion is also required. The role assists in the selection and evaluation of experts, manages litigation by checking coverages and legal expenses, and confers with attorneys on case direction. Participation in special projects, training programs, and assisting in the training of junior Claims Service Specialists are expected. The specialist will keep management informed of activities and problems, provide information to interested parties and local agents, successfully complete all required training, and meet basic claim handling performance standards. Additionally, the role involves managing and tracking claims referred to Subrogation counsel, daily navigation and management of E-Subro Hub, and preparing well-written contentions for arbitration filings. Stretch assignments will be managed with oversight based on experience.

Requirements

3-5 years of equivalent work related experience
2 or more years as a Claim Service Specialist II
Demonstrated success in handling PIP, BI, MD2
Where applicable pass the state licensing requirements
Valid driver's license in good standing
Excellent communication, customer service and collaboration skills

Nice To Haves

Stretch assignments based on experience

Responsibilities

Investigate and resolve first and third party material damage, WC, PIP, BI, GL and Property claims.
Provide guidance and direction to legal counsel during the litigation process.
Act as a mentor to new employees.
Timely completion of all case activities, maximizing customer service and minimizing net loss payout.
Contact all insureds, claimants and witnesses that may have information relating to the loss.
Visit accident locations to examine, photograph and diagram physical facts and conduct neighborhood canvasses.
Input and retrieve information using the automated claims system, request checks, form letters and other correspondence.
Evaluate case facts determining coverage, liability and reserves, and report on settlement.
Interpret and evaluate medical reports to determine if they are applicable to the claim.
Monitor legal and medical billings and investigate for proper charges and pay accordingly.
Negotiate settlements with individuals, attorneys, and other insurance carriers within their granted settlement authority level.
Pursue subrogation and arrange for salvage to obtain the maximum recovery.
Prepare detailed scope of damages on property losses and bring to conclusion.
Assist, when requested, in the selection and evaluation of experts as needed.
Manage litigation, checking to ensure that coverages are not exceeded, that legal expenses are adequate, and confer with attorney about case direction and disposition.
Participate in special projects or training programs.
Assist in the training of Claims Service Specialists II and below.
Keep management informed of activities and problems within assigned area of responsibility.
Provide information to all interested parties, including the local agents, by answering routine questions regarding the status of the claim.
Successfully complete all required training and applications.
Meet basic claim handling performance standards.
Manage and track all claims referred to Subrogation counsel.
Daily navigation and management of E-Subro Hub.
Prepare well written contentions for arbitration filings, including Special arbitrations, when coverage, liability and/or damages are in dispute.
Manage stretch assignments based on experience with oversight.