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    Director-Specialty Claims - Philadelphia, United States - RQIHUS

    RQIHUS
    RQIHUS Philadelphia, United States

    2 weeks ago

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    Description

    Job Description

    Job Description

    JOB PURPOSE

    Directly handles complex claims or oversees TPAs handling same. Conducts due diligence analyses as part of the evaluation to determine whether to acquire potential portfolios. Provides acknowledged technical expertise and resolves high complexity and exposure claims, typically in the casualty context. Has significant responsibility and works autonomously.

    KEY RESPONSIBILITIES

    • Works with and assists M&A Team to evaluate claims portfolios of potential acquisitions
    • Confirms coverage of claims and assesses potential liability by reviewing policies and documents submitted in support of claims
    • Analyzes coverage and communicates coverage positions
    • Conducts, coordinates, and directs investigation into loss facts and extent of damages
    • Directs and monitors assignments to experts and outside counsel
    • Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure
    • Recognizes significant potential exposure on claims
    • Sets reserves within authority or makes claim recommendations concerning reserve changes to manager
    • Negotiates and settles claims either directly or indirectly
    • Prepares appropriate reports to senior leaders and business partners
    • Audits files handled by R&Q Claims and vendors
    • Leads or participates in special projects
    • To maintain compliance with any applicable UK or International statutory or regulatory obligation as required by the role. This includes but not limited to obligations arising from:
      • The prudent management of the business.
      • Placing due regard on the interests of customers.
      • Observing rules on Sanctions and financial crime.
      • Regulatory requirements and local licensing restrictions.
      • Promoting and follow the Group's whistleblowing procedures

    SKILLS/KNOWLEDGE

    • Strong skills with Microsoft365 suite of products, including Excel/PowerBI/Sharepoint
    • Capable of working in a small office environment
    • Capable of working independently and meeting assigned deadlines
    • Ability to analyze, interpret and write professional documents
    • Able to respond to internal and external inquiries accurately and effectively and/or complaints
    • Comfortable with presenting information to corporate executive level
    • Strong analytical and problem-solving skills
    • Strong organization and time management skills
    • Ability to deliver outstanding customer service
    • Strong desire for continuous improvement and sense of urgency
    • Ability to work autonomously and within an interdisciplinary team
    • Experience leading others preferred

    EDUCATION

    • College degree or equivalent experience
    • Must have or be eligible to receive claims adjuster licenses
    • CPCU or other industry designation a plus

    EXPERIENCE

    • 15+ years' experience handling complex specialty and direct claims or JD with at least 10 years' experience handling complex claim

    WORK ENVIRONMENT

    • Usual office work conditions
    • Travel to mediations, trials, and conferences as required
    • Remote work option
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