What are the responsibilities and job description for the Senior Claims Technical Services Specialist position at Apex Systems?
Job#: 3031604
Job Description:
The purpose of this role is to oversee the examination, evaluation, and processing of complex Claims estimates and paid Claims values,
ensuring adherence to policy terms and conditions in alignment with the QBE Claims Philosophy. The role also entails supporting the claims
function in specific insurance classes to drive operational efficiency, efficient claims settlement, and fair resolution of claims disputes in line
with company guidelines and philosophy.
The selected candidate will manage the complete investigation, evaluation and resolution of assigned portfolio of complex claims emanating
the lawyers professional and miscellaneous professional liability business segments, Engages, directs and manages external advisors and
vendors including legal service professionals, discovery vendors, data and security experts and consultants across highly complex portfolio of
matters.
Your new role
Manage a diverse portfolio of complex claims which includes conducting fact, liability and loss investigations and interpreting insurance
contracts in an effective and efficient manner
Evaluate and negotiate the resolution of assigned claims in a timely manner, within appropriate authority and in accordance with applicable
laws, regulations, statutes, best practices and Department of Insurance (DOI) compliance
Drive the highest level of customer care, responsiveness, and satisfaction when managing assigned claims to deliver superior claim
outcomes
Collaborate with outside representative counsel to formulate litigation strategy ensuring achievement of desired outcome and effective
litigation management strategies
Directs and manage external advisors and vendors including legal service professionals, discovery vendors, data and security experts and
consultants.
Oversee projects and planning surrounding departmental initiatives to achieve strategic objectives
Analyze, develop and determine appropriate case reserves on all assigned claim files and recommend changes where necessary to ensure
actuarial accuracy
Advise on specific professional liability areas of specialization and coordinates efforts to disseminate information and guide learning and
thought leadership in those areas; serve as the subject matter expert
Represent QBE by participating in and attending industry seminars or authoring articles pertaining to professional liability subjects
Collaborate with Underwriters to identify, understand and address novel or complex risks to appropriately price and negotiate terms including
participation in sales calls and requests for proposals (RFPs)
Manage relationships with external vendors to deliver accurate, timely, and cost-effective solutions.
Take ownership for personal development and career planning, and development of required skills, tools, techniques, and technology to
continually add value to the organization.
Manage budgeted resources by anticipating expenditures, accurately forecasting resource needs/costs and properly accounting for
expenses to meet requirements and achieve fiscal responsibility
Required Education
Bachelor's Degree or equivalent combination of education and work experience
Required Experience
8 years relevant experience
Preferred Competencies/Skills
View Details: Job Requisition Change: 346880 Senior Claims
Technical Specialist - Financial Lines
Generate original, innovative solutions to difficult or unusual situations
Identify and locate information and facts which are necessary and relevant for the purposes of evaluating a claim
Financial and business acumen and awareness of financial responsibility
Quickly change direction when working on multiple projects or issues
Properly document investigation findings and preserve evidence in accordance with internal and external laws and procedures
Use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems
Assume a methodical approach to a given situation and develop a systematic procedure as a response
Develop effective negotiation strategies and prepare a plan of action
Build and capitalize on beneficial internal and external relationships including competitors
Actively contributes towards continuously improving performance and mentor team with feedback, on-the-job skill enhancement opportunities
and career advice
Build and establish constructive and cooperative working relationships and open lines of communication
Utilize effective communication skills to influence and persuade decision makers
Manage a diverse and extensive portfolio of management and professional liability claims with varying levels of complexity and activity.
Collaborate with internal resources to resolve difficult claims situations and drive resolution opportunities with internal and external
stakeholders
Preferred Education
Juris Doctor
General office jobs: Work is generally performed in an office environment in which there is not substantial exposure to adverse environmental
conditions. Must have the ability to remain in a stationary position for extended periods of time. Must be able to operate basic office
equipment including telephone, headset and computer. Incumbent must be able to lift basic office equipment up to 20 lbs.
MUST HAVE: Architects and Engineer Errors and Omission claims
EEO Employer
Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Employee Services Department at or .
Apex Systems is a world-class IT services company that serves thousands of clients across the globe. When you join Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRated's Best of Staffing in Talent Satisfaction in the United States and Great Place to Work in the United Kingdom and Mexico. Apex uses a virtual recruiter as part of the application process. Click for more details.
Apex Benefits Overview: Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection. We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure. Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts. In terms of professional development, Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6 months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Apex has a dedicated customer service team for our Consultants that can address questions around benefits and other resources, as well as a certified Career Coach. You can access a full list of our benefits, programs, support teams and resources within our 'Welcome Packet' as well, which an Apex team member can provide.
Job Description:
The purpose of this role is to oversee the examination, evaluation, and processing of complex Claims estimates and paid Claims values,
ensuring adherence to policy terms and conditions in alignment with the QBE Claims Philosophy. The role also entails supporting the claims
function in specific insurance classes to drive operational efficiency, efficient claims settlement, and fair resolution of claims disputes in line
with company guidelines and philosophy.
The selected candidate will manage the complete investigation, evaluation and resolution of assigned portfolio of complex claims emanating
the lawyers professional and miscellaneous professional liability business segments, Engages, directs and manages external advisors and
vendors including legal service professionals, discovery vendors, data and security experts and consultants across highly complex portfolio of
matters.
Your new role
Manage a diverse portfolio of complex claims which includes conducting fact, liability and loss investigations and interpreting insurance
contracts in an effective and efficient manner
Evaluate and negotiate the resolution of assigned claims in a timely manner, within appropriate authority and in accordance with applicable
laws, regulations, statutes, best practices and Department of Insurance (DOI) compliance
Drive the highest level of customer care, responsiveness, and satisfaction when managing assigned claims to deliver superior claim
outcomes
Collaborate with outside representative counsel to formulate litigation strategy ensuring achievement of desired outcome and effective
litigation management strategies
Directs and manage external advisors and vendors including legal service professionals, discovery vendors, data and security experts and
consultants.
Oversee projects and planning surrounding departmental initiatives to achieve strategic objectives
Analyze, develop and determine appropriate case reserves on all assigned claim files and recommend changes where necessary to ensure
actuarial accuracy
Advise on specific professional liability areas of specialization and coordinates efforts to disseminate information and guide learning and
thought leadership in those areas; serve as the subject matter expert
Represent QBE by participating in and attending industry seminars or authoring articles pertaining to professional liability subjects
Collaborate with Underwriters to identify, understand and address novel or complex risks to appropriately price and negotiate terms including
participation in sales calls and requests for proposals (RFPs)
Manage relationships with external vendors to deliver accurate, timely, and cost-effective solutions.
Take ownership for personal development and career planning, and development of required skills, tools, techniques, and technology to
continually add value to the organization.
Manage budgeted resources by anticipating expenditures, accurately forecasting resource needs/costs and properly accounting for
expenses to meet requirements and achieve fiscal responsibility
Required Education
Bachelor's Degree or equivalent combination of education and work experience
Required Experience
8 years relevant experience
Preferred Competencies/Skills
View Details: Job Requisition Change: 346880 Senior Claims
Technical Specialist - Financial Lines
Generate original, innovative solutions to difficult or unusual situations
Identify and locate information and facts which are necessary and relevant for the purposes of evaluating a claim
Financial and business acumen and awareness of financial responsibility
Quickly change direction when working on multiple projects or issues
Properly document investigation findings and preserve evidence in accordance with internal and external laws and procedures
Use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems
Assume a methodical approach to a given situation and develop a systematic procedure as a response
Develop effective negotiation strategies and prepare a plan of action
Build and capitalize on beneficial internal and external relationships including competitors
Actively contributes towards continuously improving performance and mentor team with feedback, on-the-job skill enhancement opportunities
and career advice
Build and establish constructive and cooperative working relationships and open lines of communication
Utilize effective communication skills to influence and persuade decision makers
Manage a diverse and extensive portfolio of management and professional liability claims with varying levels of complexity and activity.
Collaborate with internal resources to resolve difficult claims situations and drive resolution opportunities with internal and external
stakeholders
Preferred Education
Juris Doctor
General office jobs: Work is generally performed in an office environment in which there is not substantial exposure to adverse environmental
conditions. Must have the ability to remain in a stationary position for extended periods of time. Must be able to operate basic office
equipment including telephone, headset and computer. Incumbent must be able to lift basic office equipment up to 20 lbs.
MUST HAVE: Architects and Engineer Errors and Omission claims
EEO Employer
Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Employee Services Department at or .
Apex Systems is a world-class IT services company that serves thousands of clients across the globe. When you join Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRated's Best of Staffing in Talent Satisfaction in the United States and Great Place to Work in the United Kingdom and Mexico. Apex uses a virtual recruiter as part of the application process. Click for more details.
Apex Benefits Overview: Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection. We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure. Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts. In terms of professional development, Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6 months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Apex has a dedicated customer service team for our Consultants that can address questions around benefits and other resources, as well as a certified Career Coach. You can access a full list of our benefits, programs, support teams and resources within our 'Welcome Packet' as well, which an Apex team member can provide.