Complex Claims Specialist I
About The Position
Metis/Risk Management Programs is seeking a Complex Claims Specialist I to join its Legal Team. Metis is a Roanoke-owned and operated company that provides third-party administrative services for self-insurance risk pools, as well as operational support and other solutions for its subsidiaries. The specialist determines coverage under public entity risk policies and related agreements, prepares coverage letters, and communicates decisions to insureds, third-party administrators, and brokers. The role also supports claims operations and evaluates complex litigated claims for risk exposure and settlement potential, negotiating settlements and resolving claims within policy limits. Duties may change and this description is not comprehensive.
Requirements
- College degree required.
- Strong computer skills required.
Nice To Haves
- Experience as a paralegal or legal assistant in an insurance defense firm, or experience handling casualty claims for public entities.
- Advanced knowledge of casualty claims investigation, coverage evaluation, resolution strategy, negotiation, litigation management, claims evaluation, and the insurance legal framework.
Responsibilities
- Determine coverage under public entity risk policies, including retained limits and excess of loss policies, reinsurance contracts, and facultative contracts.
- Prepare coverage letters and communicate coverage decisions to insureds, third-party administrators, and brokers.
- Support claims operations, including claim entry, evaluation, adjudication, payment, and client service.
- Evaluate complex litigated claims for risk exposure and settlement potential within policy limits.
- Negotiate settlements and resolve claims.
Benefits
- Comprehensive benefits package.
- 401(k) with a 200% match up to 6%.
- Affordable health insurance premiums with wellness incentives.
- HSA with an annual company contribution of $500.
- Company-paid individual dental insurance.
- Company-paid short-term disability insurance.
- Company-paid long-term disability insurance.
- 11 paid holidays.
- Generous vacation and sick time.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
