What are the responsibilities and job description for the Technical Claim Specialist - Property position at Church Mutual Insurance, S.I.?
What you'll be doing:
Responsible for proactively managing large, complex first-party property claims, including attorney represented matters, public adjusters, appraisals, catastrophic events, structural building damage, multiple-location losses, business income exposures, and other higher-severity claims. Ensures compliance with applicable state and federal laws and company guidelines. Establishes and adjusts reserves, negotiates settlements, and issues payments within authority limits. Collaborates with internal and external partners to support effective claim resolution. Clearly and professionally articulates claim facts, coverage analysis, and recommended strategies during roundtable discussions. Actively shares expertise with team members, contributes to training initiatives, and mentors claim representatives. Demonstrates sound judgment in identifying and escalating claims to management when issues arise or when claims exceed authority or complexity thresholds.
On any given day, you'll:
- 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.
Here's what we expect:
- Eight or more years in technical insurance claim roles with increasing responsibilities is required.
- 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.
- Necessary Knowledge and Abilities:
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.
Advanced negotiation skills.
Strong listening, verbal, and written communication skills.
Advanced knowledge of policy terminology, legal principles involving insurance, and emerging industry trends.
Effective planning and organization skills.
Ability to travel to inspect loss sites, attend mediations, depositions, etc.
Advanced knowledge of reinsurance contracts, workers compensation pools, second injury funds, etc.
Advanced negotiation skills.
Strong listening, verbal, and written communication skills.
Advanced knowledge of policy terminology, legal principles involving insurance, and emerging industry trends.
Effective planning and organization skills.
Ability to travel to inspect loss sites, attend mediations, depositions, etc.
Church Mutual 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.
Exact compensation will vary based on consideration of a variety of factors including education, skills, experience, and location.
Compensation: 82,700 to 124,100