We’re committed to putting people first – if you need an accommodation as you go through the job searching, application, and interviewing process, please click here for more information.
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Refers to claim to subrogation group or Special Investigations Unit as appropriate. Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim. Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims. Coordinates the litigation activities associated with assigned claims to ensure a timely and cost-effective resolution; attends trials as a representative of the company. Acts as senior technical professional on team, assisting team members with escalated issues. Mentors and trains new team members. Participates in Quality Review process. Participates in conducting Suit Committees, Roundtables, Arbitrations, Mediations, field investigations and may assist in conducting closed file reviews. Performs other duties as assigned. 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Under the direction of Risk Control Services (RCS) Account Consultant meets with large multi-location customers to plan IH service and coordinate service delivery with field IH staff countrywide. Supports the development of procedures and service protocols associated with IH consulting service. Work with Technical Directors to research new information and keep up to date with changing occupational health standards and guidelines. Assists RCS Field Operations consultants with preparation in completing Underwriting risk assessments regarding OD exposures. May direct and participate in training of internal and external customers as it relates to OD matters. Also provides compliance consulting services and may review work done by other less experienced professionals as required by the internal and external customers. Provide various internal departments with information and guidance as it relates to RCS, Claims, Underwriting and Distribution. 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No cold calls, all incoming warm leads. Opportunities for rewards and recognition. Must be available to work a schedule of 4 weekdays and 1 weekend day with a mid-morning start time. Example 11am-8pm (CST). 2-3 years sales experience preferred. 2 years of sales/service-related work experience required. Strong, engaging interpersonal and persuasion skills needed to close sales. Ability to communicate well to both prospects and customers. Excellent analytical, decision-making and organizational skills. Strong typing capabilities and PC proficiency. 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Reviews lawsuit documentation and supporting documents, claims file, investigation, etc. Establish actions to be taken to resolve lawsuit. Includes determining loss coverage, amounts owed, discovery plans, setting reserves and negotiations. Establishes appropriate working team (Home Office Legal, Defense Counsel and Home Office Claims) based on allegations established in suit. Responsible for managing the practices and billing activities of outside counsel. Accountable for security of financial processing of claims, as well as security information contained in claims files. Trains and mentors staff as appropriate; manages relationships and acts as liaison with various business partners (e.g., Underwriting, Reinsurance, Etc.). Keeps abreast of existing and proposed legislation, court decisions and trends and experience pertaining to specialty coverage issues. May analyze the impact upon claims policies and procedures and advises Claims. Management so appropriate action can be taken where required. Participates in special projects. Bachelor's degree and 5 to 7 years claims adjusting experience. Advanced knowledge of Commercial Casualty claims investigation, coverage evaluation, reserving & expense management, resolution strategy, negotiation, litigation management, claims evaluation as well as the insurance legal and regulatory environment required. Intermediate to advanced level of skill in the area of customer focus, problem solving, communications, gaining support, teamwork, and adaptability and demonstrated ability to work independently, achieve results and execute thoroughly. 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Manage a caseload of complex, litigated construction-related losses ($500K+) from assignment through resolution: coverage analysis, liability assessment, investigation planning, reserving, negotiation, settlement or denial where appropriate. Lead coverage interpretation and application for issues commonly encountered in construction claims: additional insureds, tenders, indemnity agreements, other insurance, SIR/deductible mechanics, primary vs. excess placement, and limits erosion. Direct litigation strategy: analyze pleadings, manage discovery and depositions, evaluate venue and trial risk, prepare for mediations and settlement conferences, and recommend and implement resolution strategies. Build and lead the working team for each matter: coordinate Home Office Legal, defense counsel, SIU when appropriate, medical and causation experts, accident reconstructionists, engineers, and other technical consultants. Select, supervise and evaluate outside counsel, including establishing budgets, staffing plans, billing guidelines expectations, and performance measures. Set and adjust reserves based on defensible analysis and develop settlement strategies that protect the company's interests while advancing timely resolution. Maintain accurate, complete file documentation and ensure secure handling of financial transactions and claim information. Collaborate proactively with Underwriting, Risk Control, Reinsurance/Excess, Product and Subrogation teams; identify and communicate trends and technical insights. Mentor and coach less-experienced claims professionals and contribute to team training, process improvements, and special projects Substantial hands-on experience handling complex, litigated Commercial General Liability and/or Construction Liability claims at high exposure levels (preferably $500,000+). Deep working knowledge of CGL and Construction Liability coverages and typical construction-related policy issues (additional insured wording, contractual indemnity, other insurance, primary/excess interaction, SIRs/deductibles). Proven litigation management experience: selecting/managing defense counsel, directing discovery strategy, preparing for mediation/trial, evaluating exposure and settlement leverage. Strong technical judgment and the ability to articulate and defend coverage and liability positions to legal, underwriting, and management partners. Track record of using and directing experts (medical, causation, engineers, reconstruction) on complex causation and damages issues. Excellent negotiation, communication and stakeholder management skills. Ability to manage multiple high-priority matters and meet deadlines under pressure. 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Serve as technical resource not only for claims staff, but also cross-functional partners, including Underwriting, Actuarial, Finance and Operations. Work with claims team and external attorneys to review coverages, investigate claims, analyze liability and damages, establish adequate indemnity and expense reserves, develop strategies and resolve claims, including, but not limited to direct participation in mediation and arbitration and active participation in settlement discussions. Perform quality assurance reviews/observations and provide feedback to team as well as action plan for development of team, where necessary. Provide regular reports to claims management regarding losses either exceeding or likely to exceed the authority level in accordance with best practices. Must be able to present effectively, produce appropriate reports and develop team and train team in these skills. Partner with underwriting managers/team to provide excellent customer service and to market and meet with brokers, risk managers and reinsurers. Demonstrate ability to forge and maintain relationships with external customers, effectively resolving concerns where necessary. Ability to effectively articulate the claims value proposition in claims advocacy meetings, account renewals and new business prospecting. Present at industry conferences or publishes external industry content. Lead short to medium-term strategic claims activities/priorities for the product line, with alignment with the strategic priorities of IronHealth and NAS Claims. Oversee projects assigned by the MMF Claim Product Lead. Support Company goals of being the most trusted global brand; delivering top quartile profitability; being the best place to work; and achieve scale where it matters. Serve as a role model for high performance to achieve strategic outcomes and leverage diversity of perspectives in service of the best solution. Other duties as assigned, including delivery on established operational goals and objectives. Bachelors' degree or equivalent training A minimum of 5 years of relevant and progressively more responsible work experience required, including at least 2 years of supervisory experience preferred. Miscellaneous Medical Facilities, Healthcare Professional Liability or medical malpractice claims experience preferred. At least 5 years claims handling within a technical specialty. Requires advanced knowledge of claims handling concepts, practices, procedures and techniques, including, but not limited to coverage issues, product lines, marketing, and product competition within the marketplace. All-lines Adjusters License is required. Requires advanced knowledge of a technical specialty. 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!important;-webkit-transition: background-color 300ms linear;-ms-transition: background-color 300ms linear;transition: background-color 300ms linear;} .fa-brands{-webkit-font-smoothing: antialiased; font-style: normal; font-variant: normal; line-height: 1; text-rendering: auto;font-family: 'Font Awesome 6 Brands'} .position-details li{list-style-type: disc;} .header-wrapper{display:none!important;}.disability p {text-align:center!important;background-color:#F0F0F0!important; height:45px!important;padding-top:12px!important;} .disability a {color:blue!important;text-decoration:underline!important;} @media only screen and (max-width: 1325px){.disability p {height:67px!important;}} @media only screen and (max-width: 675px){.disability p {height:92px!important;}} @media only screen and (max-width: 480px){.disability p {height:114px!important;}}h4{margin-top: 5px;font-weight: 600;}