- Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.
- Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information.
- Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters, estimating potential claim valuation, and following company's claim handling protocols.
- Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
- Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims.
- Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate.
- Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service.
- Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation.
- Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements.
- Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business.
- May serve as a mentor/coach to less experienced claim professionals
- Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.
- Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed.
- Demonstrated ability to develop collaborative business relationships with internal and external work partners.
- Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions.
- Demonstrated investigative experience with an analytical mindset and critical thinking skills.
- Strong work ethic, with demonstrated time management and organizational skills.
- Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity.
- Developing ability to negotiate low to moderately complex settlements.
- Adaptable to a changing environment.
- Knowledge of Microsoft Office Suite and ability to learn business-related software
- Demonstrated ability to value diverse opinions and ideas
- Bachelor's Degree or equivalent experience.
- Typically a minimum four years of relevant experience, preferably in claim handling.
- Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience.
- Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.
- Professional designations are a plus (e.g. CPCU)
-
Claims Specialist, Medical Professional
1 week ago
Context4 Healthcare Naperville, United StatesContext4 Healthcare, Inc., located in Naperville, Illinois, is a world class employer where ingenuity and passion are welcomed. We are a market leader in healthcare compliance, reimbursement and regulatory products. We value our employees, clients, and partners and dedicate our e ...
-
Claims Specialist, Property
1 week ago
Zurich Insurance Company Ltd. Schaumburg, United StatesWe are currently seeking an individual interested in expanding their insurance career in commercial property technical claims handling, while working closely with a team of individuals with varied backgrounds and experiences. · At this level, you will handle a caseload of commerc ...
-
Claims Specialist L
1 week ago
Dovenmuehle Mortgage, Inc. Lake Zurich, United States**Claims Specialist I** · Full time; Non-Exempt; 40 hours/week; Overtime as required. · Location; Lake Zurich, IL, US · **Department**:Claims/REO · Dovenmuehle Mortgage, Inc. ("Dovenmuehle") is the leading mortgage subservicing firm in the United States with several hundred finan ...
-
Complex Claims Specialist
4 days ago
CNA Insurance Chicago, United StatesYou have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest pot ...
-
Senior Claims Specialist
1 week ago
CorVel Enterprise Comp, Inc. Downers Grove, United StatesJob Description · Job Description · CorVel is hiring a remote Senior Claims Specialist. The Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to d ...
-
Workers Compensation Claims Specialist
1 week ago
Liberty Mutual Hoffman Estates, United States**Pay Philosophy** · The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in the ...
-
Senior Claims Specialist
1 day ago
CorVel Enterprise Comp, Inc. Downers Grove, United StatesJob Description · Job DescriptionCorVel is hiring a remote Senior Claims Specialist. The Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determ ...
-
Senior Claims Specialist
1 week ago
CorVel Corporation Downers Grove, United States OTHERThe Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation a ...
-
Revenue Cycle Claims Specialist
3 hours ago
USA Clinics Group Northbrook, United StatesUSA Clinics Group is seeking an experienced and highly detailed **Revenue Cycle Claims Specialist **to join our Revenue Cycle team The **Revenue Cycle Claims Specialist** is the primary source for managing patient's delinquent accounts including sending patients to collections. T ...
-
Senior Claims Specialist
1 week ago
CorVel Downers Grove, United StatesThe Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation a ...
-
Senior Claims Specialist
1 week ago
CorVel Enterprise Comp, Inc. Downers Grove, United StatesJob Description · Job Description · The Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case manage ...
-
Senior Claims Specialist
1 day ago
CorVel Enterprise Comp, Inc. Downers Grove, United StatesJob Description · Job DescriptionThe Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers an ...
-
Claims Customer Care Specialist
6 days ago
Allstate Chicago, United StatesThe world isn't standing still, and neither is Allstate. We're moving quickly, looking across our businesses and brands and taking bold steps to better serve customers' evolving needs. That's why now is an exciting time to join our team. You'll have opportunities to take risks, c ...
-
Senior Claims Specialist
2 weeks ago
CorVel Corporation Downers Grove, United States OTHERCorVel is hiring a remote Senior Claims Specialist. The Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely wi ...
-
Workers Compensation Claims Specialist
1 week ago
CNA Lisle, United StatesYou have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest pot ...
-
Workers Compensation Claims Specialist
1 week ago
CNA Lisle, United StatesYou have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest pot ...
-
Compliance and Claims Specialist
1 week ago
CS Recruiting Warrenville, United StatesNon-Asset (Traditional Brokerage), Claims · Our client's mission is to be the number one preferred third-party logistics (3PL) company for transporting commercial freight anywhere in the world. They value strong customer relationships built on trust and reliability, taking owners ...
-
Workers' Compensation Claims Specialist
1 week ago
CorVel Corporation Downers Grove, United States OTHERCorVel is hiring a Claims Specialist for our VA office. The Claims Specialist manages lower-level, non-complex and non-problematic Medical Only workers' compensation claims along with Lost Time claims involving greater complexity - within company best practices & within delegated ...
-
Workers' Compensation Claims Specialist
1 week ago
CorVel Downers Grove, United StatesCorVel is hiring a Claims Specialist for our VA office. The Claims Specialist manages lower-level, non-complex and non-problematic Medical Only workers' compensation claims along with Lost Time claims involving greater complexity - within company best practices & within delegated ...
-
Worker's Compensation Claims Specialist
6 days ago
Insight Global Downers Grove, United StatesInsight Global is looking for a Claims Specialist to join a third party workers compensation organization headquartered in Chicago, IL. The Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims ...
Complex Claims Specialist - Lisle, United States - CNA
Description
JOB DESCRIPTION
:Essential Duties & Responsibilities:
Performs a combination of duties in accordance with departmental guidelines:
May perform additional duties as assigned.
Reporting Relationship
Typically Manager or above
Skills, Knowledge & Abilities
Education & Experience
