Claims Specialist

🔥 13 hours ago

🌵 Arizona, Iowa, +2 more states – Remote

🌵 Arizona – Remote 🌾 Iowa – Remote 🤠 Texas – Remote ⛷️ Utah – Remote

💵 $85.8k - $130.4k / 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 and manage complex, multi-line, and multi-state claims, including general liability and workers’ compensation losses • Review coverage, investigate facts of loss, obtain statements, evaluate medical and loss information, and develop claim resolution strategies • Establish reserves and maintain accurate, timely claim documentation • Evaluate coverage, liability, compensability, damages, and settlement exposure, and communicate claim decisions • Identify and pursue subrogation opportunities and coordinate referrals to specialized resources • Negotiate and resolve complex claims within assigned authority • Prepare claim evaluations, settlement ranges, denial correspondence, and settlement documentation • Partner with defense counsel on litigated claims and advise clients on litigation and resolution strategies • Maintain compliance with state reporting, Medicare, excess carrier, and other claim-related requirements • Build client relationships through communication, consultation, file reviews, claim summaries, and resource coordination • Analyze claim and settlement trends to identify opportunities and support client needs • Serve as a technical resource to Claims team members • Cover Iowa, Arizona, Utah, and Texas

🎯 Requirements

• Bachelor’s degree or equivalent relevant experience • Seven years of claims adjusting experience or related experience • Must have adjusters experience in Iowa, Arizona, and Utah • Adjusters experience in Texas is preferred • Prior experience with a third party administrator (TPA) preferred • INS, AIC, SCLA, WCLA and CPCU designation preferred • Advanced knowledge of best claims practices for serious and complex injury, workers’ compensation, general liability, property, and commercial auto claims • Excellent knowledge of the claim function • Advanced analytical, investigative, and problem-solving abilities with liability and coverage • Excellent knowledge of insurance contracts, medical terminology, and legal aspects of court procedures affecting legal liability • Advanced computer skills, including claims systems • Exceptional organizational, written, and verbal communication skills, including documentation • Thorough investigative and problem-solving abilities • Excellent ability to advise, partner, and consult with diverse internal and external stakeholders • Occasional travel required • Maintain required professional licenses and continuing education

🏖️ Benefits

• Comprehensive rewards package • Tobacco-free workplaces and company vehicles

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