Complex Claims Consultant EPL Claims Specialist

TEKsystems•New York, NY

6d•$38 - $53•Remote

About The Position

This role involves managing an inventory of complex Employment Practice Liability (EPL) claims. The primary focus will be on EEOC charges, which include acknowledging incoming charges, assigning them to attorneys, and monitoring their progress to closure. While these are typically lower-level, non-litigated matters, there is a possibility for advancement to handling litigated claims for high performers. The role requires strong organizational skills to manage a significant volume of claims, with the capacity to handle 2-3 new claims per day, potentially totaling around 150 claims at a time for a full-time employee. On a contract basis, the expectation is to manage 2-3 new claims daily or approximately 10 claims per week, ensuring they are acknowledged and assigned to counsel.

Requirements

Communicate with other attorneys and brokers
Very organized and can handle significant volume
Thorough knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.
Strong communication and presentation skills both verbal and written, including the ability to communicate business and technical information clearly.
Demonstrated analytical and investigative mindset with critical thinking skills and ability to make sound business decisions, and to effectively evaluate and resolve ambiguous, complex and challenging business problems.
Strong work ethic, with demonstrated time management and organizational skills.
Ability to work in a fast-paced environment at high levels of productivity.
Demonstrated ability to negotiate complex settlements.
Experience interpreting complex specialty insurance policies and coverage.
Ability to manage multiple and shifting priorities in a fast-paced and challenging environment.
Knowledge of Microsoft Office Suite and ability to learn business-related software.
Demonstrated ability to value diverse opinions and ideas.
claims processing
insurance claim
negotiation skills
litigation skills
insurance license
Guidewire

Nice To Haves

Possibility to move into handling litigated claims if they do a great job.

Responsibilities

Manages an inventory of complex Employment Practice Liability claims, with exposures that require a specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.
Ensures exceptional customer service 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 and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters, estimating potential claim valuation, and following company's claim handling protocols.
Leads focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
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.
Realizes and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Claim, Recovery or SIU resources for further investigation.
Achieves quality standards by appropriately managing each claim to ensure that all company protocols are followed, work is accurate and timely, all files are properly documented and claims are resolved and paid timely.
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 to senior management.
Communicate with other attorneys and brokers.
Acknowledge incoming EEOC charges, assign them to attorneys, and monitor the files to closure.
Talk about settlements for EEOC charges.
Handle 2 to 3 new claims a day.
Handle about 10 claims/week that need to be acknowledged and assigned council to.