Complex Loss Specialist

Integrated Specialty Coverages, LLC

6d•$87,000 - $110,000•Hybrid

About The Position

The Complex Loss Specialist position at Golden State Claims Services reports to a Claims Supervisor or Claims Manager and will specialize in complex claims. The chief duty of the Complex Loss Specialist is to adjust the most time-intensive, complex, and high exposure losses that require a higher level of technical expertise, knowledge, and negotiating ability, for the program(s) to which she/he is assigned. The Complex Loss Specialist will have a high level of ability to provide analysis and presentations to Senior Executives and Program Executives for these complex matters and will be well-versed in leading strategic roundtable discussions to determine optimal resolution strategy.

Requirements

Minimum of 10 years of claims experience, with an emphasis on complex claims
College degree or equivalent claims management experience required.
Must hold an individual adjusting license for a designated home State and be willing to secure additional required adjusting licenses as needed
Active New York adjusters license under your name required
Proficient computer skills including Microsoft Outlook, Word, and Excel.
Ability to maintain consistent and clear communication with leadership, the team and all other external points of contact
Must be legally authorized to work in the United States.

Nice To Haves

Minimum of 10 years litigation management experience preferred.

Responsibilities

Contribute to a collaborative environment by consistently demonstrating teamwork, high motivation, positive behavior, and effort to achieve goals and objectives.
Building and maintaining productive relationships with internal and external customers, including clients, underwriting and service teams, and agents
Research applicable coverage for our insureds. Document coverage dates, limits, and restrictions
Identify and resolve any potential coverage questions. Draft reservation of rights and coverage denials for review and approval by their Supervisor/Manager
Investigate facts of the loss by securing statements and supporting documentation such as contracts, cost of repair estimates, expert reports, photos, correspondence, etc.
Document activities in writing within claim files
Exercise judgment in applying legal liability to assigned claims and will have settlement authority up to their specific authority, which may vary from carrier to carrier.
Assign defense counsel to answer and defend lawsuits where appropriate. Monitor and direct defense counsel, independent adjusters, and experts.
Identify claims with potential exposure in excess of authority and advise their Supervisor/Manager
Evaluate, set, or recommend reserves for each file they are handling.
Prepare written reports as dictated by company policy and procedures.
Handle claims within guidelines of the Fair Claims Practices 790.03
Provide insureds, claimants, underwriters, and carriers with regular updates on status of file handling.
Discuss unique and complex files with Supervisor/Manager

Benefits

medical, dental and vision insurance
401(k) plan with match
paid time off
Employee Ownership Program
Professional development opportunities
Owner Referral Program
Work from home reimbursement for remote/hybrid roles
Canary emergency financial assistance program
Life/AD&D Insurance
Confidential, Employee Assistance Program
Health Savings Account, includes company contribution
Short-term disability
Voluntary benefits - supplemental accident, critical illness, hospital insurance
Employee discounts
401(k) Plan with company match contribution
Addition Wealth Financial Wellness Program
Various Time Off Programs
11 company paid holidays