Claims Litigation Specialist

Job not on LinkedIn

🔥 7 minutes ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $100k - $130k / year

⏰ Full Time

🟠 Senior

🔴 Lead

📋 Claims Specialist

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Next Insurance

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2016

🛡️ Insurance

💸 Finance

🤝 B2B

Insurance • Finance • B2B

Next Insurance is an innovative insurance provider specializing in offering tailored insurance solutions for small businesses. They leverage technology to simplify the process of getting insured, making it more accessible and efficient for entrepreneurs. Next Insurance aims to provide transparent, affordable, and easy-to-understand insurance policies that meet the unique needs of small business owners.

📋 Description

• Interpret policy documents and legal contracts • Analyze and identify coverage and related coverage issues • Apply knowledge of insurance contracts, Unfair Claims Settlement Practices, insurance codes, civil codes, vehicle codes, arbitration rules and regulations, tort law, and claims best practices • Manage, investigate, and resolve claims within prescribed authority levels • Recommend ultimate resolution on cases exceeding authority to claims management • Handle General Liability and Casualty litigation files • Drive litigation and attend mediations, trials, and alternative dispute resolution proceedings • Communicate with policyholders, witnesses, and claimants to gather claim information and advise on appropriate action • Respond to written and telephone inquiries, including status reports • Present file materials for authority reviews and roundtables • Collaborate with nurses, doctors, attorneys, internal teams, leadership, and independent field adjusters • Comply with statutory and regulatory requirements • Meet quality assurance standards and performance goals • Set and revise case reserves according to reserving policy • Identify suspicious claims and refer them to SIU; identify third-party subrogation opportunities • Maintain security of claims financial processing and claims-file information • Provide claim-specific guidance to independent field adjusters • Advise leadership on key claim activities and exposures

🎯 Requirements

• BS/BA degree required • Advanced studies or insurance designation preferred • At least 10+ years of directly related experience with Commercial General Liability and Litigation • Strong written and oral communication, interpersonal, analytical, investigative, and negotiation skills • In-depth knowledge of multi-jurisdictional claims handling issues • Willingness to use and adapt to evolving claims-operation technologies • Ability to work independently as a self-starter • Must have or promptly obtain a Texas Independent Adjuster License • Ability to collaborate with cross-functional teams • Proven success delivering strong results in a rapidly changing claims environment • Commitment to excellence, company policies, and regulatory compliance • Team-oriented approach and ability to build strong working relationships • Comfort navigating ambiguous environments and assisting coworkers or organizational projects • Receptiveness to feedback and willingness to learn new proprietary and off-the-shelf software systems • Some travel capability, likely up to 10%

🏖️ Benefits

• Annual performance-based incentive program eligibility • Partially subsidized medical plan • Fully subsidized vision/dental options • Life insurance • Disability insurance • 401(k) • Flexible paid time off • Parental leave • Equal employment opportunities and diverse, inclusive workplace