Claims Specialist

Remote. Posted a month ago

The role

You will act as a subject matter expert in the Claims department handling high-severity and high-complexity commercial claims. You will manage, investigate, and resolve claims while driving litigation and communicating with policyholders and legal professionals.

What you will do

Interpret policy documents and legal contracts
Analyze and identify coverage issues
Manage, investigate, and resolve claims within authority levels
Recommend ultimate resolution on assigned cases to management
Drive litigation and attend mediations, trials, and alternative dispute resolution
Communicate with policyholders, witnesses, and claimants
Respond to written and telephone inquiries
Present file materials for authority and roundtables
Work with nurses, doctors, and attorneys on file reviews
Set and revise case reserves

Required qualifications

BS/BA Degree
At least 10+ years of directly related experience with Commercial General Liability and Litigation
Strong written and oral communication skills
Strong interpersonal, analytical, investigative, and negotiation skills
In-depth knowledge of multi-jurisdictional claims handling issues
Willingness to utilize and adapt to evolving technologies
Must be a self-starter and able to work independently
Must have, or be able to promptly obtain, a Texas Independent Adjuster License
Effective communication, presentation, negotiation, and persuasion skills
Ability to collaborate with cross-functional teams
Ability to achieve results in a rapidly changing claims environment
Some travel capability, likely up to 10%

Nice to have

Advanced studies or insurance designation

Benefits

Partially subsidized medical plan
Fully subsidized vision/dental options
Life insurance
Disability insurance
401(k)
Flexible paid time off
Parental leave

About the company

ERGO NEXT is a technology-led, full-stack provider of small business insurance. Since 2016, they have helped hundreds of thousands of small business customers across the United States.