[Hiring] Senior Claims Representative - General Liability @Vermont Mutual Insurance

Role Description

This is a fully remote position for candidates located in the Northeast.

• Directly handle a diverse claims caseload including multiple coverage feature types and a large percentage of losses of moderate complexity and financial severity.
• Claims assigned involve coverage issues or litigation.
• Possess demonstrated expertise in handling significant bodily injury claims involving comparative negligence theories and defenses.
• Well versed in all coverages written with an emphasis on difficult losses and exposures.
• Capable of seeing difficult adjustments through final resolution using a variety of settlement techniques.
• Conclude claims promptly and equitably within the provisions of the policy contract and in accordance with known damages and legal requirements.
• All files handled must comply with claim handling guidelines and all other job expectations, regulations, and requirements.

Qualifications

• Bachelor’s degree in business, insurance or a related field, or its equivalent.
• Five or more years of relevant technical claim handling experience with demonstrated achievement and progressive responsibilities; or a combination of education and experience from which comparable knowledge and skills are acquired.
• Appropriate state Adjuster’s License(s) where required by law.
• Advanced knowledge of the technical aspects of casualty claims.
• Demonstrated commitment to professional development through the attainment of recognized industry designations such as AIC, AEI, SCLA, CPCU programs, etc.
• Fully developed skills in specialized technical disciplines; including extensive knowledge of relevant contract and tort law.
• Sound understanding of the insurance industry and company operations.
• Strong analytical and negotiating skills.
• Very good oral and written communication skills.
• Demonstrated ability to exercise sound judgment in dealing with professional issues.
• Ability to work effectively with a wide range of outside firms and organizations.
• Ability to collaborate effectively with company management, peers, and claim support staff.
• Proficiency with PC applications including Microsoft Office (Word, Excel & Outlook); experience with imaging programs and claims handling systems preferred.
• Ability to perform job responsibilities under stressful situations.

Requirements

• Conduct and coordinate loss investigations on all assigned claims.
• Negotiate the settlement of claims within authorized amounts or specific file authority.
• Maintain accountability for all assigned claims until disposition is reached.
• Recommend further action on claims exceeding authority limits.
• Document all activity on assigned claims and assist in the control of independent vendors.
• Review new losses and files on diary to ensure reserve adequacy while keeping management informed of adverse developments.
• Monitor loss adjustment expenses and manage costs of third-party service providers.
• Utilize vendors judiciously to ensure maximum value from services.
• Review coverage questions and suggest interpretations to Claim Supervisor for approval.
• Refer appropriate coverage matters to the Claim Supervisor and/or Claim Manager.
• Ensure appropriate file handling, documentation, special reporting, and expense control of all files handled inclusive of MSP compliance.
• Provide accurate, courteous, and timely information to all eligible external and internal customers concerning claim status and other claim inquiries.
• Present reports and lead discussions on files requiring roundtable reviews with peers and management.
• Provide service calls on policyholders and agencies as needed.
• Draft coverage correspondence, including reservation of rights and coverage disclaimer along with composing detailed correspondence to insureds, claimants, attorneys, etc.
• Attend trials, depositions, EUOs, and mediations where deemed beneficial or required by jurisdiction.
• Suggest improvements to processes within the department to increase the level and quality of service provided to internal and external customers.
• Effectively follow direction on complicated or high-exposure matters and recommend appropriate reserves on claim files within specific authority.
• Perform other duties or special projects as required or as assigned.

Benefits

• The salary range reflected is a good faith estimate of base pay for the position.
• This role is incentive compensation and benefits eligible.
• Individual salary will ultimately be determined based on individual experience, skills, qualifications, and geographic location.

Company Description

Employees in this job classification may be based in either a typical office environment or from a remote location or residence as determined by management.

• Predominately sedentary office position with high frequency of keyboarding/computer work required.
• Occasional overnight travel.
• Potentially subject to inclement weather and stressful situations with respect to claim disputes.