The Senior Claims Representative is responsible for managing a caseload of professional liability claims from intake through resolution, including both litigated and non-litigated matters. The role involves detailed coverage evaluation, strategic claim handling, and close collaboration with defense counsel, insureds, and internal stakeholders.
Job Description
- Manage a desk of miscellaneous professional liability claims of varying complexity across multiple professions
- Handle both litigated and non-litigated claims from inception through resolution
- Analyze coverage and identify risk transfer opportunities where applicable
- Establish and adjust reserves in line with claim exposures
- Oversee litigation strategy, including expert selection, budgeting, and coordination with defense counsel
- Develop and execute claim resolution strategies, including settlement evaluation and negotiations
- Participate in mediations and settlement discussions within authority levels
- Draft detailed coverage letters and maintain consistent communication with internal and external stakeholders
- Monitor and manage allocated loss adjustment expenses, including bill review and payment coordination
- Maintain accurate and compliant claim file documentation
- Ensure adherence to regulatory and licensing requirements
- Attend mediations, trials, or meetings as needed (occasional travel required)
Key Requirements
- Bachelor’s degree required
- Active adjuster license required
- 3+ years of experience handling professional liability claims
- Prior experience managing litigated claims
- Strong coverage analysis and coverage letter drafting experience
- Excellent negotiation and litigation management skills
- Strong written and verbal communication abilities
- Highly organized with the ability to manage multiple priorities in a fast-paced environment
- Ability to work independently while collaborating in a virtual team setting
- Proficiency with Microsoft Office and standard claims systems
- Industry designations (AIC, SCLA, CPCU) preferred; Juris Doctorate a plus
- Strong attention to detail and sound judgment in complex or sensitive situations
