Senior Complex Claims Specialist
Berkley
- Nashville, TN
- Permanent
- Full-time
- Evaluate and assess complex insurance claims to determine coverage, liability, and potential fraud, ensuring adherence to company policies and industry regulations.
- Conduct thorough investigations, including gathering documentation, statements, and evidence, to support claims decisions and mitigate risks.
- Communicate effectively with policyholders, claimants, legal representatives, and other relevant parties to explain claim decisions, negotiate settlements, and address inquiries.
- Collaborate with internal teams, including underwriting, and actuarial departments, to ensure a comprehensive understanding of the claims process and contribute to process improvements.
- Provide quality customer service and ensure file quality, timely coverage analysis and communication with insured based on application of policy information to facts or allegations of each case.
- Establishes and maintains appropriate initial and subsequent loss and expense reserves throughout the life of the claim.
- Develop litigation plan with defense or coverage counsel, including discovery and legal expenses, to assure effective resolution and to satisfy customers.
- Attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
- Managing vendors involved with claim files, i.e. Independent Adjusters, Defense Attorneys, and Coverage Counsel
- Bachelor’s degree and/or Juris Doctorate, preferred.
- Insurance related designation (AIC, SCLA and/or CPCU), preferred.
- Have, or ability to obtain adjuster license in required states
- 7+ Years of Commercial Claim Experience – Multiple Lines of Business, preferred.
- Claims handling experience in all lines of property and casualty commercial insurance
- Candidate will possess excellent communication (verbal/written), organizational and interpersonal skills.
- Excellent analytical and problem-solving skills
- Self-starting, self-motivating and capable of making decisions independently.