Complex Claims Specialist - E&S (Remote)

Selective Insurance Company of America
1d$108,000 - $163,000Remote

About The Position

Selective Insurance is seeking an E&S Complex Claims Specialist to handle the company's most complex and challenging claims. This is a fully remote position. Responsibilities of this position include coverage analysis, investigation, evaluation, negotiation and disposition of assigned claims. Candidate must possess strong litigation management skills to aggressively manage litigation activities, budgets and claim outcomes while considering the overall impact to the customer and company. The individual in this position will also ensure claims are processed within company policies, procedures, and within individual's prescribed authority with exceptional standards of performance. This individual should possess strategic though process skills to effectively and efficiently manage loss exposures. Job duties will include communication and collaboration with key stakeholders, training, development and providing thought leadership where requested. In addition, position may require travel to mediations, arbitrations, settlement conferences, trials or other proceedings which may account for up to 20% of the specialist time. All job duties and responsibilities must be carried out in compliance with applicable legal and regulatory requirements.

Requirements

  • Experience in complex coverage analysis and significant large loss evaluations.
  • Superior communication and strategic negotiation and claim disposition skills along with proven problem-solving skills.
  • Excellent presentation skills and moderate proficiency with standard business-related software (including Microsoft Outlook, Work Excel, and PowerPoint).
  • Sufficient keyboarding proficiency to enter data accurately and efficiently.
  • Multi-State licensing with strong understanding of Medicare reporting & compliance preferred.
  • Must have valid state-issued driver’s license in good standing and be able to drive an automobile.
  • College degree preferred.
  • 8+ Casualty claims handling experience
  • A minimum of 5 years handling cases of a complex nature with a primary P&C carrier.
  • New York Labor Law experience required.
  • Ability to write coverage letters is required.

Nice To Haves

  • Experience with E&S claim preferred but not required.
  • Habitability, assault and battery and Coverage B experience preferred.
  • Carrier experience preferred.

Responsibilities

  • Effectively evaluate and resolve coverage issues for all lines of business and all liability claim types.
  • Investigate the claims through telephone, written correspondence, and/or personal contact with claimants, attorneys, insureds, witnesses and others having pertinent information.
  • Effectively and efficiently manage vendors and expenses.
  • Timely analyze information in order to evaluate assigned claims to determine the extent of loss, taking into consideration contributory or comparative negligence. Assign medical or other experts to case and arrange for medical examinations when necessary.
  • Effectively evaluate, negotiate and resolve claims within delegated authority (ranging from $100,000 to $400,000) utilizing the appropriate denials or releases.
  • Provide required reports to claims, underwriting, reinsurance and actuarial on significant exposure cases.
  • Report on all cases going to trial on a timely basis and attend portions of trials when warranted or where requested by management.
  • Ensure proper referrals and timely updates to appropriate Reinsurer(s).
  • Ability to handle or oversee Extra-Contractual, EPLI, Social Services and E&O claims against the Company.
  • Must be able to drive an automobile to travel within territory. Car travel represents approximately 10-25% of employee’s time and a valid driver’s license.

Benefits

  • Selective Insurance offers a total rewards package that includes a competitive base salary, incentive plan eligibility at all levels, and a wide array of benefits designed to help you and your family stay healthy, achieve your financial goals, and balance the demands of your work and personal life.
  • These benefits include comprehensive health care plans, retirement savings plan with company match, discounted Employee Stock Purchase Program, tuition assistance and reimbursement programs, and 20 days of paid time off.
  • Additional details about our total rewards package can be found by visiting our benefits page.

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Number of Employees

1,001-5,000 employees

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