Complex Claims Specialist III - D&O And Financial Institutions E&O - Remote

TEKsystems•Dallas, TX

1d•$38 - $53•Remote

About The Position

This is a fully remote position for a Complex Claims Consultant specializing in Directors & Officers (D&O) and Financial Institutions Errors & Omissions (E&O) claims. The role involves managing an inventory of complex Public D&O and Financial Institutions E&O claims that are typically multi-year and have significant loss exposure. The specialist will follow company protocols to manage and oversee all aspects of claim handling, including coverage determinations, investigations, and resolution strategies, which may involve risk transfer, extensive negotiations, and complex litigation management. The position also focuses on ensuring exceptional customer service through continuous improvement, providing professional and timely claims services, and achieving quality and cycle time standards.

Requirements

Expert knowledge of specialty insurance industry, products, policy language, coverage, and claim practices.
Excellent verbal and written communication skills with the ability to develop collaborative working relationships, articulate very complex claim facts, analysis and recommendations in a concise manner to senior management, as well as with external business partners and customers.
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.
Extensive experience in leading complex negotiations, as well as developing and implementing resolution strategies.
Strong work ethic, with demonstrated time management, organizational skills, and an ability to work independently in a fast-paced environment.
Ability to drive results by taking a proactive long-term view of business goals and objectives.
Extensive experience interpreting D&O and E&O insurance policies and coverage.
Ability to partner with internal resources, oversee/manage outside counsel, and collaborate with other carriers.
Ability to lead 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 process
insurance claim
property & casualty insurance

Nice To Haves

CPCU
Guidewire

Responsibilities

Draft coverage letters which will have a secondary review.
Manage an inventory of complex Public D&O and Financial Institutions E&O claims, which are generally multi-year and have significant loss exposure, by following company protocols to manage and oversee all aspects of the claim handling, including coverage determinations, investigations, and resolution strategies which may include pursuit of risk transfer, extensive negotiations and complex litigation management.
Ensure exceptional customer service by driving continuous improvements for all aspects of the claim/account, providing professional and timely claims services, and achieving quality and cycle time standards.
Verify coverage, set and manage timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel as needed, estimating potential claim valuation, and following company's claim handling protocols.
Lead all activities involved with a focused investigation to determine compensability, liability and covered damages by gathering pertinent information, documenting statements from customers/claimants, and working with experts, or other parties, as necessary to verify the facts of the claim.
Drive the resolution of 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.
Establish and manage significant claim budgets by identifying, selecting and actively managing appropriate resources, delivering high quality services, and coordinating all efforts leading to timely resolution of the claim/accounts.
Discover and address subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making appropriate referrals to appropriate Claim, Recovery or SIU resources for further investigation.
Achieve quality standards by effectively 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.
Prepare and present high profile, complex information to senior leadership, customers, counsel, and others by effectively identifying high profile matters, developing executive loss summaries, coordinating and communicating resolution strategies and sharing relevant current events and case law.
Maintain subject matter expertise and ensure compliance with state/local regulatory requirements by following company guidelines, and staying current on insurance laws, regulations or trends for the specialized line of business, and may represent company in industry trade groups or other important events.
Assist with special projects as needed.
Perform additional duties as assigned.