Back to job search

Complex Claims Examiner - MPL (Remote)

  • Location:

    New York

  • Sector:

    Underwriting & Claims

  • Job type:

    Permanent

  • Salary:

    US$90000 - US$150000 per annum

  • Contact:

    Madison Hartings

  • Contact email:

    Madison.Hartings@oliverjames.com

  • Job ref:

    JOB-012023-192651_1674052029

  • Published:

    18 days ago

  • Expiry date:

    2023-02-17

  • Startdate:

    ASAP

The Role: The Complex Claims Specialist is a high-level examiner role that adjudicates assigned claims within given authority and provides operational support to the claims team. Responsibilities include: * Adjusts and resolves complex to severe claims that includes all phases of litigation * With minimal supervision, drafts complex coverage letters, including reservation of rights and denial letters * Reviews and analyses claim documentation and legal filings * Drives litigation best practices to lead defense strategy on litigated files * Mentors Claim Examiners and Associate Claim Examiners * Uses superior knowledge and experience to affect positive claim outcome via investigation, negotiation and utilization of alternative dispute resolutions * Identifies emerging exposures and claims trends * Identifies suspected fraudulent claims and tracks with special investigations unit * Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities * Develops content and conducts training for claims team and underwriters as requested

Banner Default Image

We are Oliver James

We received an average rating of 9.1 from feedback by our clients and candidates.

image.png