Senior Complex Claims Specialist

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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

• Directly handle the company’s most complex casualty and litigated claims nationwide • Proactively manage assigned claims through conclusion while controlling expenses and pursuing early resolution • Serve as subject matter expert on complex coverage issues and support reserve setting and claim resolution • Set timely, accurate, and well-documented reserves • Conduct investigations into coverage, liability, and damages and manage appropriate vendors • Prepare claim evaluations and file reviews • Develop, document, and execute negotiation plans • Maintain claim diaries and concise claim notes for case control and exposure evaluation • Collaborate with defense counsel on strategic defense and resolution strategies, budgets, and invoice reviews • Present claims in Claim Committee and Complex Roundtables and facilitate claim discussions • Attend mediations and trials as necessary • Provide expert guidance and technical support to General Casualty, Complex, Specialty, and regional claims teams • Review and communicate evaluations of serious injury, intellectual property, and high-exposure claims • Support claims adjusters, managers, directors, and claims leadership on issues requiring special attention • Promote improved technical claims handling in accordance with Best Practices • Identify, develop, and deliver training programs with Learning and Development and claims leadership • Participate in special projects to improve claims expertise and outcomes • Deliver customer service and provide insureds and agents with claim status and coverage explanations • Serve as a technical subject matter consultant and recommend technical claims-handling development opportunities

🎯 Requirements

• Bachelor’s degree, preferably in business, economics, or related field, or equivalent related experience • Ten years of experience in complex claims handling or claims litigation, including at least three years of claims litigation experience • Insurance designations such as AIC, CPCU, and/or other insurance education preferred • Exceptional knowledge of litigation management, coverage, and technical file handling • Strong knowledge of claims-function theory and practice • Ability to evaluate legal liability, damages, coverages, and exposure • Excellent knowledge of insurance contracts, medical terminology, and legal aspects of court procedures affecting commercial-lines liability • Leadership, collaboration, and negotiation skills • Knowledge of computers and claims systems • Strong organizational, written, and verbal communication skills • Customer service skills • Advanced investigative and problem-solving abilities • Travel required (20%) • Valid driver’s license with an acceptable motor vehicle report per company standards required if driving

🏖️ Benefits

• Outstanding benefits with life, medical, dental, vision and prescription drug coverage • Competitive paid time off plan • Full day of volunteer time off annually • 401(k) plan match • Pension plan • OneEMC bonus plan • Recognition and anniversary awards • Professional development and growth opportunities • Tuition reimbursement • Wellness initiatives to improve team member well-being and reduce health insurance costs • Flexibility to dress for your day • Opportunities for alternative work arrangements