Senior Technical Claims Specialist

Brookfield Wealth Solutions, Ltd•Omaha, NE

71d•Onsite

About The Position

We are looking for a highly capable Senior Complex Claims Technical Specialist to join our team and work in our Omaha office. We work together in the office five days a week in order to strengthen our culture, build team connections, and drive profitability. This role will directly report to the SVP, Claims Legal based in Chicago and is responsible for providing technical support on insurance coverage disputes and major cases in litigation assigned to Adjusters throughout the US. This is a 100% in-office position. Candidates must be able to work on-site at a designated company office during standard business hours.

Requirements

A deep knowledge of claims adjudication and focus on customer service typically achieved through: At least seven years’ experience handling insurance coverage issues and disputes, with exposure of $100,000 or more, for Commercial General Liability (including Bodily Injury and Property Damage, Construction Defect, New York Labor Law, Garage, Inland Marine, Excess, Property, and Environmental.
A J.D. from an accredited law school
Must have good business acumen (i.e. understand how an insurance company works and makes money, including how this role impacts both Argo Group and our customers’ ability to be profitable).
Ability to regularly exercise discretion and independent judgment with respect to matters of significance. This role primarily faces problems and issues that are difficult and require an understanding of a broader set of issues.
Must have excellent communication skills and the ability to build lasting relationships.
Exhibit natural curiosity in order to consistently explore and consider all options and is not governed by conventional thinking.
A strong focus on execution in getting things done right. Proven ability to consistently produce and deliver expected results to all stakeholders by: Finding a way to achieve success through adversity. Being solution (not problem) focused Thinking with a global mindset first.
Successful traits (flexibility, ability to thrive in change, being resourceful on your own) necessary to work in a fast paced environment that is evolving constantly.
Excellent evaluation and strategic skills required.
Strong claim negotiation skills a must.
Knows how claims reserving techniques are used and how to assess whether a claim reserve is accurate.
Must possess a strong customer focus.
Effective time management skills and ability to prioritize workload while handling multiple tasks and deadlines.
Demonstrates innovative thinking and regularly shares ideas to help the team whenever possible
Ability to articulate the financial value of your work at multiple responsibility levels inside our clients’ business which may include CEO.
Demonstrates inner strength. Has the courage to do the right thing and demonstrates it on a daily basis.
Proficient in MS Office Suite and other business-related software.
Polished and professional written and verbal communication skills in order to present information accurately and effectively.
The ability to read and write English fluently is required.
Must demonstrate a desire for continued professional development through continuing education and self-development opportunities.
Licensed Claims Examiner (Based on state) Must possess or be willing to quickly obtain a license in each jurisdiction requiring a license to adjudicate first party claims within 120 Days.
Ability to travel about 5% of the time (average one day per month), sometimes overnight.

Responsibilities

Working with limited oversight under broad management direction, adjudicate highly complex claims and insurance coverage disputes mostly for our casualty line of business, at the highest authority limits on assignments reflecting the highest degree of technical complexity and coordination in liability and litigated claims, potentially with major impact on departmental results.
Conducting detailed information gathering, analysis and investigation to find solutions to issues that are numerous and undefined.
Oversee defense panelist, including monitoring and evaluating operations and performance.
Conduct file reviews to ensure accuracy, attend mediations and settlements, and participate in pre-trail calls as necessary.
Provide technical guidance in properly setting claim reserves.
Reporting to senior management and underwriters on insurance coverage issues and claims trends and developments.
Investigating insurance coverage issues and claims promptly and thoroughly
Analyzing claims forms, policies and endorsements, client instructions, and other records to determine whether the loss falls within the policy coverage.
Investigating claims promptly and thoroughly, including interviewing all involved parties.
Managing claims in litigation
Managing diary timely and complete tasks to ensure that cases move to the best financial outcome and timely resolution.
Properly setting claim reserves, taking into account how different policy wordings impact the claims reserving process.
Identifying, assigning, and coordinating the assignment and coordination of expertise resources to assist in case resolution.
Preparing reports for file documentation
Applying creative solutions which result in the best financial outcome.
Negotiates highly complex settlement packages, sets reserves and authorizes payment within scope of authority, settling claims in most cost effective manner and ensuring timely issuance of disbursements.
Processing mail and prioritizing workload.
Completing telephone calls and written correspondence to/from various parties (insured, claimant, etc.).
Having an appreciation and passion for strong claim management.