Technical Claim Specialist-Workers Compensation

CHURCH MUTUAL INSURANCE COMPANY in Englewood, CO

  • Industry: Legal - Attorney - Firm
  • Type: Full Time
  • Compensation: $107,730.00 - 104,020.00 / Year*

Overview

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.

Responsibilities

  • 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.

Qualifications

  1. Prior Experience:

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

  1. 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.
  1. 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.

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.


* Estimated salary


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