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    Resolution Specialist - Houston, United States - The Gray Insurance Company

    The Gray Insurance Company
    The Gray Insurance Company Houston, United States

    2 weeks ago

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    Description

    The Commercial Claims Resolution Specialist investigates commercial casualty claims. This position will gather claimant information, conduct on-scene investigations, work with outside counsel, and attend appropriate claim-related legal proceedings.

    DUTIES AND RESPONSIBILITIES

    • Investigate commercial Casualty claims, including Auto and General Liability performing on-scene/site investigations when appropriate
    • Verify coverage of incoming claims and oversee the accuracy of claim set-up
    • Obtain initial medical reports, appraisals, and statements from claimants/witnesses
    • Monitor incoming medical/legal reports and respond accordingly
    • Obtain expert opinions as needed
    • Complete timely reports and claim file diaries
    • Effect settlements within prescribed limits
    • Ensure timely claim payments
    • Maintain accurate claim file reserves
    • Submits recommendations to Claims manager on cases exceeding settlement authority
    • Manage outside counsel regarding strategy on litigated claims, making sure Claims management is involved on those above authority level
    • Attend and participate in mediation
    • Attend trials, giving testimony as needed
    • Monitor vendor participation and apply gained knowledge/results appropriately
    • Pursue all viable avenues of subrogation
    • Visit assigned insureds at least once quarterly or as needed
    • Ensure up-to-date knowledge and application of statutory/regulatory laws along each coverage line
    • Ensure accurate Medicare Section 111 compliance filings
    • Mentor, assist, and share experience/expertise with peers
    • Assist Branch Manager as needed
    • Obtain required credit hours to maintain an adjuster license
    • Other duties as assigned/ required.
    REQUIRED SKILLS
    • Excellent communication skills with management, employees, and outsiders.
    • Excellent computer skills with knowledge of Microsoft Office Suite or similar software.
    • Ability to work independently with minimum supervision.
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