Technical Claims Specialist

Job description

• Investigates, evaluates, negotiates, and resolves assigned property claims of high complexity.
• Determines the facts of the loss, coverage compensability, and the degree of exposure by the unit of coverage.
• Reviews and analyzes, and applies policy conditions, provisions, exclusions, and endorsements pertinent to a variety of losses.
• Establishes timely and accurate property claim and expense reserves.
• Communicates clearly and professionally with the customer, or their representative, by telephone and/or written correspondence regarding all aspects of the claims process.
• Serves as Subject Matter Expert on the claims process, by identifying and suggesting process improvement ideas to increase efficiency in the claim process.
• In coordination with the Unit Managers, leads and participates in complex projects.
• Trains and certifies the senior resolutions level; develop the training material for the functional claims training.
• Determines settlement amounts based on independent judgment, estimates of actual cash value and replacement value, contractor estimate validation, appraisals, and application of applicable limits and deductibles.
• Negotiates and conveys property claim settlements within authority limits to insureds.
• Controls damage exposures through proper usage of cost containment tools.
• Maintains an effective diary system to ensure timely resolution and document claim file activities following established procedures and state regulations.
• Provides excellent customer service to meet the needs of the insured, agent, and all other internal and external customers.
• Partners with counsel to develop litigation plans and adhere to applicable guidelines.
• Completes training sessions to remain current with industry trends and changes.
• Performs other duties as required.