Role Description
The Claims Senior Professional manages complex claims processes, including investigating, evaluating, and resolving high-severity claims in compliance with company standards and regulations. This role ensures timely adjudication while minimizing risk exposure and maintaining superior customer and broker relationships.
Key Responsibilities:
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Investigate, assess, and resolve complex claims within authority limits.
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Analyze policy coverage and liability to determine appropriate claim outcomes.
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Develop and execute strategies to mitigate potential financial risk exposure.
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Collaborate with legal counsel, underwriters, and external vendors as necessary.
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Prepare comprehensive reports and documentation for claim decisions.
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Ensure all regulatory requirements and compliance standards are met.
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Manage communications with clients, brokers, and internal stakeholders throughout the claims process.
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Participate in audits and quality control reviews to ensure best practices.
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Contribute to process improvement initiatives within the claims department.
Qualifications
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Bachelorβs degree in business, insurance, risk management, or related field is preferred.
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5 or more years of experience handling claims, preferably in specialty or complex lines.
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Demonstrated expertise in managing complex or high-risk claims scenarios.
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Experience working with brokers, legal professionals, and regulatory agencies.
Requirements
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Must hold and maintain all required licenses in all U.S. states where licensing is required to perform the duties of this position.
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Insurance-specific certifications (e.g., AIC, CPCU) are preferred.
Benefits
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Access to medical, dental, vision, life, disability, and AD&D insurance.
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Tax-advantaged savings accounts.
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401(k) plan with company match.
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Generous paid time off programs, including company holidays, vacation and sick days, new parent leave, and more.
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Eligible positions may also qualify for restricted stock units and/or a deferred compensation plan.