Claims Specialist

• Responsible for the resolution of moderate complexity and moderate exposure first party property claims in multiple jurisdictions.
• Handles low to moderate low exposure claims.
• Confirms coverage of claims by reviewing policies and documents submitted in support of claims.
• Analyzes coverage and communicates coverage positions.
• Ability to draft coverage position letters independently.
• Utilizes acceptable investigation claims handling and settlement techniques that achieve cost effective and timely closure results by obtaining, reviewing and analyzing documentation, policy provisions and other records.
• Conducts, coordinates, and directs investigation into loss facts and extent of damages.
• Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure.
• Sets reserves within authority or makes recommendations concerning reserve changes to manager.
• Utilizes diary system to pro-actively resolve outstanding issues and to ensure timely processing and closure of the claim.
• Negotiates and settles claims directly with claimant.
• Prepares reports by collecting and summarizing information.
• Participates in special projects or assists other team members as requested.
• Provides timely service throughout the life cycle of the claim by meeting all service level agreements, initiating timely contact to all appropriate parties, and responding to incoming inquiries according to company policy and procedures.
• Identifies subrogation opportunities and fraud potential and makes appropriate referrals.

Claims Examiner II

• Investigate, evaluate, and help resolve claims
• Responsible for the resolution of claims of low complexity and exposure
• Review claim information to determine coverage and recommend appropriate next steps
• Assist with evaluating potential exposures on claims and alerting Management or internal partners when needed
• Adhere to Fair Claims Practices Regulations and claims handling guidelines
• Prepare and distribute claim reports
• Build strong relationships with internal stakeholders including Underwriting
• Collaborate with departments across Markel including Claims Vendor Management, Finance, Actuarial, Risk Management, and IT
• Mentor with senior examiners and managers to observe negotiation strategies and claim resolution practices
• Travel to other claim offices and conferences as needed

Associate Claims Examiner

• Investigate, negotiate and settle complex primary and excess policy casualty claims including negligence, premise liability, commercial automobile, construction bodily injury, construction defect, product liability, and sexual assault
• Investigate and analyze coverage under primary and excess casualty insurance policies; make coverage determinations; draft routine and complex coverage correspondence; effectively communicate coverage positions to policyholders and other stakeholders; manage claims involving coverage litigation
• Manage litigation filed nationwide against insureds; appoint, direct and manage defense counsel; proactively work toward expeditious and economical resolution of claims; assist internal business partners, including claims vendor management, disbursement and legal collections teams with defense counsel, bill payment and collection issues
• Communicate with underwriting as needed to manage claims and to alert of any significant developments
• Promptly communicate with management on adverse case developments and provide information on pertinent issues affecting professional liability product lines
• Proven ability to work in a collaborative team environment
• Analyze and convey summations of complex issues; recognize alternative approaches and develop action plans, both orally and in written form
• Maintain and adhere to internal guidelines and procedures
• Ensure proper adherence to internal reporting requirements
• Contribute and assist in the implementation of a wide range of initiatives, discussion and action plans brought forth by management
• Participate in agent related functions and meetings as required
• Actively participate in the ongoing training and development of the claims examiners

Executive Claims Examiner

• To analyze Medical Only & Lost-Times Workers Compensation claims on behalf of our valued clients to determine benefits due.
• Ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution.
• Investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Workers' Compensation Claims Adjuster

• To analyze mid to high level Workers Compensation Lost-Time claims on behalf of our valued clients to determine benefits due.
• Ensuring ongoing adjudication of claims within service expectations.
• Investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Workers Compensation Claims Adjuster, NJ & VA Jurisdictions, Dedicated Client, Capped Caseload

• Confirms coverage of personal property claims by reviewing policies and documents submitted in support of claims
• Analyzes coverage and communicates coverage positions
• Conducts, coordinates, and directs investigation into loss facts and extent of damages
• Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure
• Sets reserves within authority or makes claim recommendations concerning reserve changes to manager
• Maintains accurate system data and documentation by collecting, recording, analyzing and summarizing information
• Negotiates and settles claims either directly or indirectly
• Prepares reports by collecting and summarizing information
• Identifies subrogation opportunities and fraud potential and makes appropriate referrals
• Strong emphasis on customer service to both internal and external customers is a major focus for this role particularly as it relates to service to our insureds
• Participates in special projects or assists other team members as requested
• May be asked to take on higher complexity claims as needed

Associate Claims Analyst

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Workers Compensation Claims Examiner

• Investigate, analyze, and determine the extent of liability concerning first party homeowner property losses and damages.
• Effectively communicate and negotiate with policyholders, agents, public adjusters, attorneys, and service providers via phone, email, and internal systems to accurately document claim details.
• Successfully manage a pending claim load at varying stages of the claims process.
• Interpret and apply the details of an insurance policy to ensure the accuracy of payments and claims declinations.
• Interpret and apply computer generated loss estimates, engineer’s reports, and construction terminology.
• Update and maintain comprehensive claim handling notations in our electronic claims management system and other related applications.
• Mentor our mid and associate level claims representatives.

Complex Claims Representative

• Review emails and Microsoft Teams messages at the start of each shift
• Log into internal systems and begin processing claims
• Accurately enter and review data in a high-volume environment
• Monitor team chats and adjust workflow based on team needs
• Complete assigned tasks and meet productivity goals
• Follow scheduled breaks and lunch per company policy

Part-time Claims Processor

• To analyze and process complex bodily injury auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability, and evaluating the scope of damages.
• Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly.
• Responsible for litigation process on litigated claims.
• Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims.
• Reports large claims to excess carrier(s).
• Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.
• Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage.
• Communicates claim action/processing with insured, client, and agent or broker when appropriate.
• Performs other duties as assigned. Supports the organization's quality program(s).

Claims Examiner, Auto, Bodily Injury

• To analyze complex or technically difficult medical malpractice claims; to provide resolution of highly complex nature and/or severe injury claims.
• To coordinate case management within Company standards, industry best practices and specific client service requirements.
• To manage the total claim costs while providing high levels of customer service.
• Analyzes and processes complex or technically difficult medical malpractice and long term care claims by investigating and gathering information to determine the exposure on the claim.
• Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions.
• Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life.
• Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement.
• Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients.
• Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost.
• Represents Company in depositions, mediations, and trial monitoring as needed.
• Communicates claim activity and processing with the client; maintains professional client relationships.
• Ensures claim files are properly documented and claims coding is correct.
• Refers cases as appropriate to supervisor and management.

Senior Claims Specialist – Professional Liability, Long Term Care, Medical Malpractice

• Examining and appropriately interpreting insureds’ policies, forms in force, and other records to determine coverage and extent of the company’s exposure and policy limitations
• Applying knowledge of multiple state statutes, including the insurance code of ethics, rules, regulations, and guidelines
• Desk reviewing, drafting, adjusting, and approving estimates of damage and loss amounts for structural damages, mitigation, remediation, etc
• Using varying methods of investigation, including taking recorded statements, consulting with experts, identifying property damage, and reviewing documentation
• Keeping active communication and working with customers, their representatives, contractors, and experts throughout the Claims process from first notice of the claim through repair completion
• Working with public adjusters and attorneys that may represent the insured(s) and responding to all notices and letters in accordance with state guidelines

Senior Claims Adjuster, Large Loss

• Investigate, analyze, and determine the extent of liability concerning first party homeowner property large losses and damages of $100K+.
• Negotiate settlements and make payments within scope of authority, settling claims timely, and in the most cost-effective manner.
• Effectively communicate with policyholders, agents, and service providers via phone, email, and internal systems to accurately document claim details.
• Effectively manage loss and expense reserves to ensure accurate and timely reserving practices on all large loss claim exposures.
• Create and maintain comprehensive claim handling documentation in the electronic claims management system and related applications including the completion and escalation of Large Loss Reports (LLR’s).
• Ability to successfully manage a pending claim volume at varying stages in the claims process.
• Interpret and apply the details of an insurance policy to ensure the accuracy of payments and claims declinations.
• Ability to understand, computer generated loss estimates and construction terminology.
• Update and maintain comprehensive claim handling notations in our electronic claims management system and other related applications.

Claims Specialist – Large Loss

• Confirms coverage of claims by reviewing policies and documents submitted in support of claims
• Analyzes coverage and communicates coverage positions
• Conducts, coordinates, and directs investigation into loss facts and extent of damages
• Directs and monitors assignments to experts and outside counsel
• Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure
• Sets reserves within authority or makes claim recommendations concerning reserve changes to manager
• Negotiates and settles claims either directly or indirectly
• Prepares reports by collecting and summarizing information
• Adheres to Fair Claims Practices regulations
• Assist in training and mentoring of specialists
• Serves as technical resource to subordinates and others in the organization
• Review and approve correspondence, reports and authority requests as directed by manager
• Participates in special projects or assists other team members as requested
• Travel to mediations, trials, and conferences as required
• Represents Markel’s claims expertise on external panels and industry forums
• Coordinates loss information for senior business stakeholders and presents during monthly/quarterly business meetings
• Contributes to maintenance of claims guidelines and best practice procedures
• Delivers technical training to colleagues and external contacts as appropriate
• Ensures effective vendor and litigation management on claims with a focus on minimizing indemnity exposure and mitigating vendor and legal expense
• Steps in for manager to assume managerial duties when manager is unavailable or requires assistance

• Analyze coverage and communicate coverage positions
• Conduct, coordinate, and direct investigation into loss facts and extent of damages
• Confirm coverage of claims by reviewing policies and documents
• Draft coverage position letters
• Evaluate information on coverage, liability, and damages
• Handle claims in all jurisdictions and litigated/non-litigated property damage claims up to $250,000
• Identify losses for SIU reporting
• Provide excellent customer service to insureds
• Represent Markel in mediations as required
• Set reserves within authority or recommend changes to manager

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Claims Specialist II

• Responsible for the resolution of claims of average complexity and low to mid exposure
• Investigate, evaluate, negotiate and resolve assigned claims
• Analyze and determine appropriate direction on coverage, investigation, evaluation and resolution of claims
• Make recommendations regarding reserve changes to Management
• Recognize potential exposures and prepare alerts to Management and internal business partners
• Prepare and distribute claim reports
• Participate fully in training and development programs
• Build strong relationships with internal stakeholders including Underwriting
• Support special projects as assigned
• Mentor with senior examiners and managers

Claims Examiner I – General Liability

• Manages an inventory of claims to evaluate compensability/liability
• Conducts claim investigations to confirm coverage and to determine liability, compensability and damages
• Determines and may negotiate appropriate claim settlements/reserves within prescribed authority
• May attend arbitrations, mediations, depositions, or trials
• Conveys routine to moderately complex information regarding coverage and settlements to insureds, claimants, and external partners
• May authorize payments in accordance with assigned authority limit and ensures payments are made in a timely manner
• Maintains accurate and detailed claim files, including all correspondence, reports, and settlement agreements
• Performs other duties as assigned.

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