Claims Specialist - Executive Claims Specialist - Complex Litigation and Bodily Injury Focus
📋 Role Overview & Responsibilities
Come grow with James River Insurance!
James River Insurance is an excess and surplus lines segment of James River Group Holdings, Ltd. and operates on an approved non-admitted basis in 50 states and Washington, DC. Since 2003, James River has provided thousands of commercial property and casualty customers with innovative and creative solutions for particular insurance needs.
At James River Insurance, we are committed to providing a stable and rewarding work environment supported by our Core Values and Guiding Principles: Integrity, Accountability, Innovation, Customer Service, Communication, and Teamwork. We are proud of our recent national recognition as a 2023, 2022, and 2021 Top Workplaces USA awards.
James River Group Holdings, Ltd. is a Bermuda-based insurance holding company which owns and operates a group of specialty insurance and reinsurance companies. The Company operates in three specialty property-casualty insurance and reinsurance segments: Excess and Surplus Lines, Specialty Admitted Insurance and Casualty Reinsurance. The Company tends to focus on accounts associated with small or medium-sized businesses in each of its segments. Each of the Company's regulated insurance subsidiaries are rated "A-" (Excellent) by A.M. Best Company.
Job Summary
The Claims Specialist will manage a caseload of pending insurance claims with minimal supervision. Job functions include the following: Analyzing insurance claims to determine applicable coverage; Analyzing claims to determine the extent of the insured’s or insurer’s liability; Reviewing and evaluating damages and determining strategies for resolution; settling claims in accordance with policy provisions and within authority level. The Claims Specialist will engage in verbal and written communication with brokers, claimants and policyholders. The Claims Specialist will ensure that state claims handling requirements are met, and internal guidelines are followed. The Claims Specialist will handle claims in accordance with James River Claims Best Practices. The Claims Specialist will function independently and will act as a resource person and consultant on issues within area of specialty.
Duties And Responsibilities
Continuously exhibit and uphold Core Values of Integrity, Accountability, Communication and Teamwork, Innovation and Customer ServicePerform coverage, liability, and damage analysis on all claims assignmentsInvestigate allegations, determine facts based on evidence and interviewsDraft disclaimers and reservation of rights letters when coverage issues ariseAssign limited investigations and appraisals to independent licensed professionalsNegotiate settlements, mitigate losses, and control expensesManage litigated files in accordance with Litigation Management GuidelinesProvide technical guidance, assistance and training as needed for claims staff and other departmentsMaintain a high level of communication with leadershipWork within authority limits on assignments that reflect a high degree of technical complexity and coordinationWill be recognized as the company consultant within specialty areaHandle special projects related to specialty area as needed
Knowledge, Skills And Abilities
Excellent written and verbal communication skillsStrong analytical skillsStrong negotiation skillsAbility to work independentlyExcellent organizational skillsProficient computer skillsAbility to work in a team environment and take directions from a Claims ManagerAbility to work on assignments that require a high technical level of expertise due to complexity and exposure, under minimal supervisionRecognized as having a high level of expertise in claim handling and suit managementAbility to provide technical guidance and assistance, and train less experienced Claims ExaminersPossess demonstrated technical knowledge and skills, including product and industry, reflective of successful progress
Experience And Education
Claims Specialist
High school diploma requiredCollege degree preferredAdvanced degree or law degree preferredMinimum of seven years claims handling experienceExtensive expertise in specific specialty area of claims (i.e. PL, M&C, GL)Experience working with complex coverage issuesMulti-jurisdictional claims and litigation experienceAdjuster license and/or certifications desired preferred
Executive Claims Specialist
High school diploma requiredCollege degree preferredMinimum of fifteen years multi-line claims handling experience, with concentration in litigationProject management and process implementation experience preferredExtensive expertise in specific specialty area of claims (i.e. PL, M&C, GL)Experience working with complex coverage issuesAdjuster license and/or certifications preferred
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