Senior Claims Specialist
Westfield Health
Senior Claims Representative/Claims Specialist
Cisco
full-time
Posted on:
Origin: • 🇺🇸 United States • Ohio, Oklahoma
Visit company websiteJob Level
Senior
About the role
- Mid-Continent Group focusing on construction defect losses nationwide with complex litigated claims.
- Manage an inventory of claims of significant size, complexity, or a specific line of business.
- Investigate and maintain claims: Review and evaluate coverage and liability.
- Secure necessary information (i.e.: reports, policies, appraisals, releases, statements, records, or other documents) in the investigation of claims.
- Work toward the resolution of claims files, and attend arbitrations, mediations, depositions, or trials as necessary.
- Affect settlements/reserves within prescribed limits and submit recommendations to supervisor on cases exceeding personal authority.
- Convey the most complex information (coverage, decisions, outcomes, negotiations, etc.) to all appropriate parties maintaining a professional demeanor in all situations.
- Ensure that claims payments are issued in a timely and accurate manner.
- Ensure compliance of claims handling pursuant to all state, legal, statutory, and regulatory bodies to comply with all company procedures and requirements.
- Obtain and maintain appropriate licensure in applicable venues.
- Serve as the technical expert on a product(s) and/or line of business.
- Evaluate and make recommendations to executive management on internal and external issues of strategic importance to a product(s) and/or line of business.
- Plan for and ensure that performance targets are met.
- Interact with underwriting and marketing regarding claims trend issues.
Requirements
- Generally, 5+ years of experience handling small to medium size construction defect losses and litigation.
- Bachelor’s degree or equivalent is required.
