Technical Claim Specialist-Casualty (1788)

Church Mutual Insurance Company Denver , CO 80208

Posted 4 months ago

Responsible for handling large, complex claim files, including litigated matters, catastrophic claims, umbrella claims, punitive damage claims, severe injury, long duration indemnity, permanent total disability, structural building damage, multiple location damage, including business income exposure and other extensive exposure claims, in accordance with applicable state and federal laws. Set reserves and settle claims within level of authority. Direct work of defense attorney. Actively share knowledge with team members, contribute to training programs, and mentor other claim representatives.

For the right candidate, remote work may be an option. There is also an opportunity to work from one of our additional office locations, which include Merrill, WI, Madison, WI, and Mechanicsburg, PA.

Duties and Responsibilites

  • Perform claim tasks timely and document claim files appropriately. Proactively manage claim activities to ensure fair claim resolution. Handle all claims in accordance with state and federal laws.

  • Make complex coverage decisions by gathering information necessary to make an informed decision in a fair, equitable, and ethical manner. Deny losses within authority level, providing detailed explanation, citing facts, and policy language.

  • Perform a thorough investigation based upon the type, complexity, and severity of the claim. Inspect loss sites as necessary. Upon completion of the investigation, analyze and evaluate the potential high exposure and extensive damages, including potential full or partial liability and compensability denials. Formulate and document an action plan based on the covered damages and injuries.

  • Determine and set reserves based on the most probable outcome of the claim, within authority level. Evaluate and negotiate directly with insured, claimant, or claimant's attorney on all cases within authority level. Review claim facts and exposure with claims management, as appropriate, to guide claim strategy. Make complete, accurate, and timely payments within authority for covered losses.

  • Maintain a professional, courteous, and helpful approach when communicating in-person, on the phone, or through email and other correspondence with internal and external customers, business partners, and brokers.

  • Provide knowledge and guidance to other claim handlers regarding claim strategy, coverage interpretations, and in-depth jurisdictional and legal nuances. Field questions from team members related to coverage/compensability decisions.

  • Investigate and refer identified claims to Loss Recovery Services, as applicable.

  • Direct work of defense attorney through collaboration on claim strategy and resolution. Ensure defense attorney is adhering to Litigation Management guidelines. Manage claim expense by concluding vendor assignment when vendor is no longer adding value to the claim.

  • Engage in direct investigation, control, and settlement negotiations when outside adjusting and legal services are not necessary or available.

  • Attend mediations, depositions, and trials. Present complex claim files during roundtables and claims committee meetings.

Essential Functions

  • Perform claim tasks timely and document claim files appropriately. Proactively manage claim activities to ensure fair claim resolution. Handle all claims in accordance with state and federal laws.

  • Make complex coverage decisions and deny claims within authority levels.

  • Perform a thorough investigation based upon the type, complexity, and severity of the claim.

  • Complete, analyze, and evaluate the potential exposure and damages and formulate an action plan.

  • Determine and set reserves and make complete, accurate, and timely payments for covered losses within authority level.

  • Meet the needs of internal and external customers, business partners, and brokers in a professional and appropriate manner.

  • Investigate and refer identified claims to Loss Recovery Services, as applicable.

  • Assign and direct vendor partners to aid in the investigation and evaluation of the claim.

  • Act as resource to other claim handlers.

  • Attend mediation and present a summary of complex claim files during roundtables and claims committee meetings as requested.

Required Skills

  • Ability to obtain and maintain state adjusting license requirements and complete continuing education requirements.

  • Advanced knowledge of recoveries such as subrogation, reinsurance, apportionment, and deductibles.

  • Advanced knowledge of reinsurance contracts, workers compensation pools, second injury funds, etc. Strong listening, verbal, and written communication skills. Effective planning and organization skills.

  • Ability to travel to inspect loss sites, attend mediations, depositions, etc.

  • Advanced knowledge of policy terminology, legal principles involving insurance, and emerging industry trends.

  • Advanced negotiation skills.

Required Experience

  • Eight or more years in technical insurance claim roles with increasing responsibilities is required.

Education

  • Bachelor's degree preferred. A combination of equivalent education and/or experience may be considered in lieu of a degree.

  • Evidence of continuing education in the insurance industry is required.

  • Additional legal education or law degree is highly desirable.

  • Completion of AIC and/or CPCU is preferred.

Church Mutual Insurance Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.


icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Powerapps Global Technical Specialist

Microsoft Corporation

Posted 1 week ago

VIEW JOBS 9/13/2019 12:00:00 AM 2019-12-12T00:00 PowerApps is an enterprise service for innovators everywhere to connect, create and share business apps with your team on any device in minutes. Harnessing the power of the Microsoft Cloud and with seamless integration to the vast Microsoft platform including Dynamics 365, Office 365 and Azure, PowerApp's is enabling our customers to unlock new business agility. Microsoft if seeking an experienced Solution Architect to advise a targeted set of enterprise customers on building sophisticated business apps that enable experiences across Dynamics 365, Office 365 and Azure to meet and exceed their business transformation needs. In performing this role, the Solution Architect will help our customers understand the opportunity for transformation via automation of business processes with PowerApps, Flow and the Common Data Service. They will help architect proposed solutions that align PowerApps to enhance and drive business value, while also advising our customers how this meets their future technical vision and strategy. The PowerApps Solution Architect is at the forefront of business application trends and has direct access to the Product Group and the future roadmap. The ability to influence and articulate the future direction of the PowerApps strategy is important as is the ability to demonstrate how PowerApps, Microsoft Flow and the Common Data Service can leverage Microsoft's broad array of technology and services. The success of this role depends on collaboration with both generalists and specialists in the Microsoft subsidiary teams (including Services, Product Engineering and other sales and pre-sales roles) and in our partner ecosystem. QUALIFICATIONS: * 3+ years hands-on technical experience with Common Data Service, Sharepoint, Dynamics 365 XRM, and/or Azure Services, or equivalent competitive solutions. * PowerApps Canvas and Model App development highly desirable. * 5+ years experience with Mobile Application Development, REST APIs and UX Design with the associated data models. * Ability to work through development examples with the customer in one-off engagement hackathons. * 5+ years experience in delivering architecture design sessions, deep technical presentations and industry-focused demos to LOB owners and C-Suite executives. * Ability to quickly grasp customer/partner strategic business objectives to articulate an engagement plan that addresses these objectives. * 3+ years experience delivering effective technical presentations. Demonstrated ability in leading by example, sharing insight and enabling peer groups (peers, customers, partners, technical/architect community). Travel approximately 30% within US Strategic Sales Engagement: * Drive the One Microsoft story by crafting presentations that combine PowerApps with other Microsoft technologies to create compelling industry solutions. This could include Dynamics 365, SharePoint, IoT, Machine Learning, Power Apps, BI, Azure services, etc. * Provide pre-sales solution architecture guidance and POC support. Design and deliver compelling highly impactful engagements with customers. * Demonstrate deep industry knowledge of Microsoft PowerApps, Microsoft Flow and the Common Data Service solution to qualified prospects and customers to assist with their digital transformation. * Present and speak meaningfully about the development environment, governance, and architecture of PowerApps, Microsoft Flow and Common Data Service solutions as well as their integration with Dynamics 365, Office 365, Azure Cloud and supporting technologies. * Utilize established practices to engage customers and influence outcomes such as App-in-a-Day, Admin-in-a-Day, Hackathons and other methods. * Establish and maintain credible technical relationships at the executive level. Customers, Field Sellers and Partners will view you as a strategic advisor. Field Technical Enablement: * Collaborate with Microsoft field sellers to identify key solution areas and top industry value propositions that are enabled by PowerApps, Microsoft Flow and the Common Data Service. * Illustrate to field sellers how to position the PowerApps, Microsoft Flow and Common Data Service as an extension of their existing investment in the Microsoft Cloud, Dynamics 365, Office 365 and Azure to meet customers digital transformation strategy. * Host and present at PowerApps, Microsoft Flow and Common Data Service at internal, partner and customer evangelism events showcasing Microsoft's business application capabilities. * Participate in additional enablement activities such as Ready, DTA, bootcamps and other learning events. Technical Thought Leadership/Evangelism: * Identify competitive and market trends in the business application (low code/no code) domain and create reusable industry assets for field sellers. * Contribute whitepapers, blogs, technical communities and technical briefings to the greater PowerApps, Microsoft Flow and Common Data Service community to establish yourself as a technical thought leader and to advance product adoption. * Work alongside strategic Microsoft partners to bring new solutions to market and provide technical guidance. * Work with product teams to facilitate product updates, identify functional gaps and influence future product investments by representing the 'voice of the customer'. Microsoft Corporation Denver CO

Technical Claim Specialist-Casualty (1788)

Church Mutual Insurance Company