- Handle, negotiate, and resolve first and third-party commercial claims, ensuring compliance with company policies and state regulations.
- Conduct thorough investigations, maintaining constant communication with customers and relevant internal and external stakeholders.
- Document all key activities, contacts, and statements, including comprehensive outlines of claim requirements.
- Demonstrate proficiency in medical terminology, treatment, and injury descriptions.
- Recognize and assess potential damage related to injuries.
- Manage the claim authorization process and complete loss investigations using appropriate techniques.
- Evaluate compensability and exposure, identifying subrogation opportunities and suspicious claims.
- Prepare accurate and timely reports and state filings as required.
- Establish and maintain accurate reserves, adhering to state regulatory compliance requirements.
- Verify, analyze, and apply coverage correctly.
- Develop negotiation strategies for claims resolution, considering state compliance and company policies.
- Create resolution plans based on a thorough analysis of facts, defenses, compensability, and statutory/case law.
- Keep policyholders, underwriting, and agents informed of file status and other relevant matters.
- Participate in presentations, meetings, or visits related to claims resolution, service, or technical issues.
- Stay updated with relevant continuing education requirements.
- Minimum of 7 years of multi-line claims experience.
- Current Texas claims adjuster license required; additional licenses are a plus.
- Preferred experience in handling claims across multiple jurisdictions.
- Familiarity with Contractual Risk Transfer concepts and anti-indemnity laws.
- Strong attention to detail and accuracy in documentation and data management.
- Excellent written and verbal communication skills, with a strong ability to listen effectively.
- Adept at resolving differences in opinions and misunderstandings through open discussion.
- Demonstrates accountability for actions and holds self and others responsible to organizational standards.
- Exceptional organizational skills and the ability to prioritize work effectively.
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Technical Claims Specialist - Houston, United States - General Search & Recruitment
Description
Job Description
Job DescriptionTechnical Claims SpecialistHouston, TX
A well-respected Insurance Carrier is seeking a qualified and experienced Technical Claims Specialist to join our dynamic team.
As a Technical Claims Specialist, you will play a crucial role in managing and resolving a variety of commercial claims, including general liability, property, Inland Marine, automobile bodily injury, property damage, and potentially worker's compensation claims.
If you have a strong background in claims handling, exceptional communication skills, and a commitment to delivering excellent service, we invite you to apply for this exciting opportunity.
Key Responsibilities:
