Casualty Claims Specialist

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $78.7k - $119.6k / year

⏰ Full Time

🟠 Senior

🔴 Lead

📋 Claims Specialist

👻 Ghost score 0%

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EMC Insurance Companies

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1911

🛡️ Insurance

Insurance

EMC Insurance Companies is a mutual insurance firm providing specialized business insurance solutions. They focus on commercial property insurance, liability insurance, workers' compensation, and business owners' policies. With a strong emphasis on personalized service, EMC collaborates closely with local agents to deliver comprehensive and tailored coverage. EMC is committed to understanding the unique challenges faced by its policyholders, offering risk management and loss control resources to help businesses safeguard their assets. Known for their dedicated partnerships and exceptional customer service, EMC ensures that businesses are prepared for the unexpected with their superior insurance solutions.

📋 Description

• Investigate, evaluate, negotiate, and dispose of highly complex auto and casualty claims, including claims in litigation • Review claim notices, contracts, state statutes, and policies to verify coverage, deductibles, and payees • Investigate complex coverage issues with Coverage Counsel and/or outside counsel • Contact insureds and claimants, obtain statements, and document investigations in claims systems • Analyze reports, claim forms, documents, Medicare modules, reserves, and recovery opportunities • Prepare claims and participate in claims roundtables • Set timely and adequate reserves • Manage litigation, including lawsuits, defense counsel, legal budgets, mediations, arbitrations, and depositions • Prepare coverage analyses, reservation of rights letters, lawsuit analyses, litigation plans, and damage evaluations • Negotiate and settle claims with attorneys, insureds, and claimants • Investigate Medicare liens and protect liens • Prepare settlement and release documents and issue timely payments • Review and audit estimates, invoices, and litigation expenses • Serve as a technical resource and subject matter expert for claims team members • Assist with claims and suits outside the assigned jurisdiction • Lead or participate in casualty claims projects • Submit referrals to Estimatics, Special Investigation, Subrogation, Medical Review Units, and Coverage Counsel • Prepare risk reports and collaborate with Underwriting and Risk Improvement

🎯 Requirements

• Bachelor’s degree or equivalent relevant experience • Eight years of casualty claims adjusting experience or related experience • Relevant insurance designations preferred • Superior knowledge of best claims practices for serious and complex liability claims • Advanced knowledge of insurance contracts, medical terminology, and substantive and procedural laws • Excellent knowledge of computers and claims systems • Ability to obtain all applicable state licenses • Ability to adhere to high standards of professional conduct and code of ethics • Exceptional organizational and empathetic interpersonal skills • Thorough written and verbal communication skills • Advanced customer service skills • Ability to maintain confidentiality • Thorough investigative and problem-solving abilities • Occasional travel required • Valid driver’s license with an acceptable motor vehicle report per company standards required if driving

🏖️ Benefits

• Comprehensive rewards package; benefits details provided at www.emcins.com/careers • Work from home anywhere in the US • Tobacco-free workplaces and company vehicles