Individual contributor responsible for the overall investigation and management of Aging Services claims in multiple states. Recognized as a technical expert in the interpretation of complex or unusual policy coverages in area of expertise.
Under general management direction, works within assigned limits of broad authority on assignments requiring a high degree of technical complexity and coordination. May have regional, industry segment or company-wide scope of responsibility within specialty area.
Essential Duties & Responsibilities
1.Manages highly complex investigations of claims, including coverage issues, liability, compensability and damages. Determines if a major claim should be settled or litigated and implements an appropriate resolution strategy accordingly. Effectively manages loss costs and claim expenses.
2.Manages all types of investigative activity or litigation on major claims, including the posting of appropriate reserves in a timely manner. Coordinates discovery and litigation strategy with staff counsel or panel attorneys.
3.Negotiates highly complex settlement packages, and authorizes payment within scope of authority, settling claims in most cost effective manner and ensuring timely issuance of disbursements.
4.Coordinates third party recovery with subrogation/salvage unit.
5.Makes recommendations on claims processes and resolution strategies to management.
6.Analyzes claims activities; prepares and presents reports to management and other internal business partners and clients.
7.Works with attorneys, account representatives, agents, doctors and insureds regarding the handling and/or disposition of highly complex claims.
8.Keeps current on state/territory regulations and issues, industry activity and trends. May participate in industry trade groups.
9.Provides guidance and assistance to less experienced claims staff and other functional areas.
10. Responsible for input of data that accurately reflects claim circumstances and other information important to our business outcomes.
May perform additional duties as assigned.
Manager or above.
Skills, Knowledge & Abilities
1.Advanced technical and product specific expertise, claims resolution skill and knowledge of insurance and claims principles, practices and procedures.
2.Strong communication, negotiation and presentation skills. Ability to effectively interact with all levels of CNA's internal and external business partners.
3.Advanced analytical and problem solving skills, with the ability to manage and prioritize multiple projects.
4.Ability to deal with ambiguous situations and issues.
5.Creativity in resolving unique and challenging business problems.
6.Knowledge of Microsoft Office Suite and other business-related software.
7.Ability to adapt to change and value diverse opinions and ideas.
8.Ability to manage and prioritize multiple projects.
9.Ability to evaluate claims based on a cost benefit analysis.
10. Ability to fully comprehend complex claim facts and issues; and to further articulate analyses of claims in presentations to business partners and management as well as in internal reports.
11. Ability to implement strategies with a proactive long-term view of business goals and objectives.
Education & Experience
1.Bachelor's degree or equivalent experience. Professional designation preferred.
2.Typically a minimum eight years claims experience.