Senior Claims Examiner, Complex Liability

Gallagher•Torrance, CA

About The Position

Analyzes coverage and settles the most complex and challenging claims in one or more of Gallagher Bassett's specialty claims areas. Generally, incumbent does not work on workers compensation claims. Able to manage the full-life cycle of all assigned claims files. Analyzes coverage and determines defense obligations. Independently conducts thorough analysis and investigations necessary to determine claims exposure and recommend appropriate settlement strategies and action plans. Creates reservation of rights and coverage denial letters. Negotiates settlements with clients, client attorneys, and Public Adjusters. Interacts extensively with various parties involved in the claims process, and may recommend retaining the advice of outside experts as necessary. Prepares reserve and settlement authority requests for client and carrier approval. May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage. Has a solid understanding of claims processing and the insurance brokerage business. Has an in-depth understanding of the terminology and case law associated with their specialized claims niche/industry. Handles claims consistent with clients' and corporate policies, procedures and "best practices" and also in accordance with any statutory, regulatory and ethical requirements. Provides guidance and/or supervision to lower level adjusters. Incumbents at this level should be able to work at full case load capacity.

Requirements

High school diploma
7 years related experience working within the applicable specialty claims area.
Demonstrated ability to handle unique/challenging claims issues at a senior adjuster level.
Appropriately licensed and/or certified in all states in which claims are being handled or able to obtain the licenses/certification per local requirements.
Knowledge of accepted industry standards and practices.
Computer experience with related claims and business software.
Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges.
Analytical skill necessary to make decisions and resolve issues inherent in handling of claims.
Ability to successfully negotiate the settlement and disposition of claims including the ability to interpret related documentation.

Nice To Haves

Bachelor's Degree highly preferred.
10 or more years of prior experience adjusting claims in applicable specialty area highly preferred.

Responsibilities

Analyzes coverage and settles the most complex and challenging claims in one or more of Gallagher Bassett's specialty claims areas.
Manage the full-life cycle of all assigned claims files.
Analyzes coverage and determines defense obligations.
Conducts thorough analysis and investigations necessary to determine claims exposure and recommend appropriate settlement strategies and action plans.
Creates reservation of rights and coverage denial letters.
Negotiates settlements with clients, client attorneys, and Public Adjusters.
Interacts extensively with various parties involved in the claims process, and may recommend retaining the advice of outside experts as necessary.
Prepares reserve and settlement authority requests for client and carrier approval.
May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage.
Provides guidance and/or supervision to lower level adjusters.