Complex Claims Specialist

CostcoIssaquah, WA
$98,000 - $114,000Hybrid

About The Position

Costco Wholesale is seeking a Complex Claims Specialist to direct and oversee the investigation, evaluation, and resolution of Commercial General & Automobile Liability claims outsourced to a third-party administrator (TPA). This role involves evaluating the Company’s exposure, deciding on the appropriate course of action to protect against loss and mitigate costs, and providing reserve and settlement recommendations in accordance with Company policy. The position is within a dynamic, fast-paced environment undergoing transformation, offering an opportunity to be part of a globally recognized company.

Requirements

  • 6-10 years general liability claims experience directing serious bodily injury liability claims and litigation of significant exposure and complexity on a regional or national level.
  • Strong knowledge of contract, tort, subrogation, contribution, indemnity and other related law.
  • Able to effectively direct and control work of outside counsel and TPA.
  • Superior verbal and written communication skills.
  • Excellent evaluation and analytical skills, including ability to recognize new or changing information that could affect the claims handling strategy and/or potential claims cost.
  • Able to interpret and apply applicable laws and regulations, determine the appropriate course of action and present solutions to resolve claims within multi-million-dollar retention.
  • Knowledge of risk management information systems and statistical data.
  • Able to articulate understanding of the impact that effective claims management has on the business.
  • Scheduling flexibility to meet the needs of the business; available for occasional travel.

Nice To Haves

  • High School Diploma or GED.
  • Bachelors’ Degree preferred.
  • Senior Claims Law course work or other industry training/designations.
  • Ability to assess actual damages associated with claims and conduct settlement negotiations within assigned authority limits.
  • Ability to analyze legal documents and medical records.
  • Extensive knowledge of litigation practices and procedures.

Responsibilities

  • Directs and oversees thorough and impartial investigations; determines investigation method and detail as appropriate.
  • Acts as a liaison between TPAs, legal counsel and vendors to manage claims, including attending trials, arbitration, mediations, ADR and face-to-face negotiations.
  • Provides technical direction and training to TPAs, outside counsel and department members to ensure compliance with applicable state and federal laws.
  • Monitors service quality provided by TPAs, outside counsel, structured settlement vendors and makes recommendations to management.
  • Ensures settlements are consistent with Company guidelines, policy and procedure.
  • Ensures claim documentation is accurate, organized and properly maintained.
  • Submits thorough and accurate reports as necessary.
  • Provides superior member service while presenting claim updates to the member.

Benefits

  • paid time off
  • health benefits - medical/dental/vision/hearing aid/pharmacy/behavioral health/employee assistance
  • health care reimbursement account
  • dependent care assistance plan
  • short-term disability and long-term disability insurance
  • AD&D insurance
  • life insurance
  • 401(k)
  • stock purchase plan
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