About this role
- Investigates claims to determine whether coverage is provided, establish compensability and verify exposure.
- Resolves claims within authority and makes recommendations regarding case value and resolution strategy to Branch Office Management and HO Examining on cases which exceed authority.
- Participates in pricing, reserving and strategy discussions with HO Examining and Examining Management.
- Works closely with staff and outside defense counsel in managing litigated files according to established litigation management protocols.
- Identifies and appropriately handles suspicious claims and claims with the potential to develop adversely.
- Identifies and appropriately handles claims with third party subrogation potential, SIF (Self-Insured Fund) and MSA (Medicare Set Aside) exposure.
- Establishes and maintains accurate reserves on all assigned files.
- Makes timely reserve recommendations to Branch Office Management and HO Examining on cases which exceed authority.
- Prepares for and attends mediation sessions and/or settlement conferences and negotiates on behalf of LMG and LMG Insureds.
- Demonstrates the ability to understand new and unique exposures and coverages.
- Demonstrates the ability to understand key data elements and claims related data analysis.
- Confers directly with policyholders on coverage and resolution strategy issues.
- Coordinates and participates in training sessions for less experienced staff, including both Complex Non-Complex staff.
A bachelor's degree or equivalent business experience is required In addition, the candidate will generally possess 5-7 years of related claims experience with 1-2 years of experience in complex claims Demonstrated proficiency in Excel, PowerPoint as well as excellent written and verbal communication skills required