Complex Claims Analyst
3.
8 Full-time 2 hours ago Full Job Description Job Title Complex Claim Analyst Location Remote or Hybrid (Manchester, NH / Rockville Centre, NY) Summary Reporting the Unit Manager, this role will be responsible for direct handling of multi-line commercial claims including Auto, General Liability and Construction Defect claims.
Duties include investigation and evaluation of coverage, liability and damages issues.
The role will be responsible for claim evaluation, establishment/recommendation of adequate reserves, litigation management, case resolution and transaction processing in alignment with the Company's and Client's Strategic Vision.
Essential Functions Directly handles and/or assists in monitoring, reviewing, and coordinating the activities involving multi-line commercial insurance claims, including analysis of coverage issues, establishment of adequate reserves, and the resolution and closure of claims.
Reviews loss notices; confirms and interprets policy coverages; establishes adequate reserves; and investigates and handles claims involving primary, umbrella and excess policies.
Ensures proper file setup, reserving, general handling and application of company procedure.
Manages litigation with Preferred Counsel under Alternative Fee Arrangements or other defense fee structures.
Pursues and maximizes all risk transfer opportunities by contract or by insurance policy language.
Assigns and manages work of defense counsel, assignment of expert witnesses and interfacing with peer carriers including design and execution of defense and indemnity contracts, evaluation of liability and damages and participation in settlement negations.
Participates in developing claims handling strategy, including defense coordination, litigation strategy and budgets, and expense control.
Records specific claims information and reports as appropriate to a manager relative to pertinent financial and general statistical records.
Maintains diary control, investigates, analyzes, and reports to ensure maintenance of proper reserves to reflect the company's exposure and reports to our Reinsurance Department to assist in providing notice to reinsurers and the Reinsurance Department's recovery of specific amounts when payment exceeds the company's retention.
Handles large volume of diverse and dynamic claims effectively.
Empowered to make decisions within job description and authority.
Seeks guidance where appropriate.
Develops creative ideas and solutions to real time business problems and /or business opportunities; Takes reasonable, calculated risks even if failure is possible.
Seeks continuous development by identifying areas for growth improvement and works with team to implement process and technical improvements Empowers self and teammates to continuously improve Company's business processes/systems and develops and escalates ideas and solutions.
Understands Key Performance Indicators and works towards those priorities.
Consistently delivers superior customer service to both internal and external business partners.
Performs special projects and assignments related to area of authority as necessary.
Maintains confidentiality.
Establishes and maintains professional relationships.
Assists in Due Diligence inquiries as assigned.
Travels as required.
Obtains and maintains claims adjuster licenses in those states requiring them.
Organizational Demonstrates alignment with Company's Commitments.
Prioritizes and organizes work in self-directed manner.
Attains and maintains knowledge of assigned department.
Performs other duties as required, including supporting and coordinating with other department colleagues.
Related Functions:
Serves on Companywide committees and projects as assigned.
Required Skills Strong analytical, interpersonal and communications skills, written and verbal, required.
Capable of working independently and meeting assigned deadlines.
Customer service oriented with the ability for developing long lasting relationships with internal and external business partners.
Experience Minimum of 2
years' experience in claims or related field.
Required Education Four-year college degree or equivalent work experience.
Preferred Education or Certification Supervisory Role None Travel As required, based upon business needs.
Work Environment / Physical Demands This position operates in a professional based collaborative environment and must have the ability to timely produce thorough, accurate work with many competing demands, deadlines, and distractions.
The position uses standard equipment such as phones, computers, copiers/printers and filing cabinets.
Noise level is moderate.
RiverStone retains the right to change or assign other duties to this position as needed.
Core Competencies Action Oriented:
Enjoys working hard; is action oriented and full of energy for the things he/she sees as challenging; seizes more opportunities than others; not fearful of acting with minimum planning Customer Focus:
Builds strong customer relationships and delivers customer-centric solutions; gains insight into customer needs, identifies opportunities that benefit the customer; builds and delivers solutions that meet customer expectations and establishes and maintains effective customer relationships.
Creativity:
Comes up with a lot of new and unique ideas; easily makes connections among previously unrelated notions; tends to be seen as original and value-added in brainstorming settings Ethics and Values:
Adheres to an appropriate (for the setting) and effective set of core values and beliefs during both good and bad times; acts in line with those values; rewards the right values and disapproves of others; practices what he/she preaches.
Learning on the Fly:
Learns quickly when facing new problems; a relentless and versatile learner; open to change; analyzes both successes and failures for clues to improvement; experiments and will try anything to find solutions; enjoys the challenge of unfamiliar tasks; quickly grasps the essence and the underlying structure of anything.
Negotiating:
Can negotiate skillfully in tough situations with both internal and external groups; can settle differences with minimum noise; can win concessions without damaging relationships; can be both direct and forceful as well as diplomatic; gains trust quickly of other parties to the negotiations; has a good sense of timing.
Problem Solving:
Uses rigorous logic and methods to solve difficult problems with effective solutions; probes all fruitful sources for answers; can see hidden problems; is excellent at honest analysis; looks beyond the obvious and doesn't stop at the first answers.
Time Management:
Uses his/her time effectively and efficiently; values time; concentrates his/her efforts on the more important priorities; gets more done in less time than others; can attend to a broader range of activities Written Communications:
Is able to write clearly and succinctly in a variety of communication settings and styles; can get messages across that have the desired effect.
Diversity, Equity, Inclusion & Belonging RiverStone Resources, LLC is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, LGBTQ+, national origin, gender identity, disability, protected veteran status, or any other characteristic protected by law.
Privacy Notice for California Residents https:
//www.
trg.
com/california-consumer-privacy-notice/.
Estimated Salary: $20 to $28 per hour based on qualifications.
8 Full-time 2 hours ago Full Job Description Job Title Complex Claim Analyst Location Remote or Hybrid (Manchester, NH / Rockville Centre, NY) Summary Reporting the Unit Manager, this role will be responsible for direct handling of multi-line commercial claims including Auto, General Liability and Construction Defect claims.
Duties include investigation and evaluation of coverage, liability and damages issues.
The role will be responsible for claim evaluation, establishment/recommendation of adequate reserves, litigation management, case resolution and transaction processing in alignment with the Company's and Client's Strategic Vision.
Essential Functions Directly handles and/or assists in monitoring, reviewing, and coordinating the activities involving multi-line commercial insurance claims, including analysis of coverage issues, establishment of adequate reserves, and the resolution and closure of claims.
Reviews loss notices; confirms and interprets policy coverages; establishes adequate reserves; and investigates and handles claims involving primary, umbrella and excess policies.
Ensures proper file setup, reserving, general handling and application of company procedure.
Manages litigation with Preferred Counsel under Alternative Fee Arrangements or other defense fee structures.
Pursues and maximizes all risk transfer opportunities by contract or by insurance policy language.
Assigns and manages work of defense counsel, assignment of expert witnesses and interfacing with peer carriers including design and execution of defense and indemnity contracts, evaluation of liability and damages and participation in settlement negations.
Participates in developing claims handling strategy, including defense coordination, litigation strategy and budgets, and expense control.
Records specific claims information and reports as appropriate to a manager relative to pertinent financial and general statistical records.
Maintains diary control, investigates, analyzes, and reports to ensure maintenance of proper reserves to reflect the company's exposure and reports to our Reinsurance Department to assist in providing notice to reinsurers and the Reinsurance Department's recovery of specific amounts when payment exceeds the company's retention.
Handles large volume of diverse and dynamic claims effectively.
Empowered to make decisions within job description and authority.
Seeks guidance where appropriate.
Develops creative ideas and solutions to real time business problems and /or business opportunities; Takes reasonable, calculated risks even if failure is possible.
Seeks continuous development by identifying areas for growth improvement and works with team to implement process and technical improvements Empowers self and teammates to continuously improve Company's business processes/systems and develops and escalates ideas and solutions.
Understands Key Performance Indicators and works towards those priorities.
Consistently delivers superior customer service to both internal and external business partners.
Performs special projects and assignments related to area of authority as necessary.
Maintains confidentiality.
Establishes and maintains professional relationships.
Assists in Due Diligence inquiries as assigned.
Travels as required.
Obtains and maintains claims adjuster licenses in those states requiring them.
Organizational Demonstrates alignment with Company's Commitments.
Prioritizes and organizes work in self-directed manner.
Attains and maintains knowledge of assigned department.
Performs other duties as required, including supporting and coordinating with other department colleagues.
Related Functions:
Serves on Companywide committees and projects as assigned.
Required Skills Strong analytical, interpersonal and communications skills, written and verbal, required.
Capable of working independently and meeting assigned deadlines.
Customer service oriented with the ability for developing long lasting relationships with internal and external business partners.
Experience Minimum of 2
years' experience in claims or related field.
Required Education Four-year college degree or equivalent work experience.
Preferred Education or Certification Supervisory Role None Travel As required, based upon business needs.
Work Environment / Physical Demands This position operates in a professional based collaborative environment and must have the ability to timely produce thorough, accurate work with many competing demands, deadlines, and distractions.
The position uses standard equipment such as phones, computers, copiers/printers and filing cabinets.
Noise level is moderate.
RiverStone retains the right to change or assign other duties to this position as needed.
Core Competencies Action Oriented:
Enjoys working hard; is action oriented and full of energy for the things he/she sees as challenging; seizes more opportunities than others; not fearful of acting with minimum planning Customer Focus:
Builds strong customer relationships and delivers customer-centric solutions; gains insight into customer needs, identifies opportunities that benefit the customer; builds and delivers solutions that meet customer expectations and establishes and maintains effective customer relationships.
Creativity:
Comes up with a lot of new and unique ideas; easily makes connections among previously unrelated notions; tends to be seen as original and value-added in brainstorming settings Ethics and Values:
Adheres to an appropriate (for the setting) and effective set of core values and beliefs during both good and bad times; acts in line with those values; rewards the right values and disapproves of others; practices what he/she preaches.
Learning on the Fly:
Learns quickly when facing new problems; a relentless and versatile learner; open to change; analyzes both successes and failures for clues to improvement; experiments and will try anything to find solutions; enjoys the challenge of unfamiliar tasks; quickly grasps the essence and the underlying structure of anything.
Negotiating:
Can negotiate skillfully in tough situations with both internal and external groups; can settle differences with minimum noise; can win concessions without damaging relationships; can be both direct and forceful as well as diplomatic; gains trust quickly of other parties to the negotiations; has a good sense of timing.
Problem Solving:
Uses rigorous logic and methods to solve difficult problems with effective solutions; probes all fruitful sources for answers; can see hidden problems; is excellent at honest analysis; looks beyond the obvious and doesn't stop at the first answers.
Time Management:
Uses his/her time effectively and efficiently; values time; concentrates his/her efforts on the more important priorities; gets more done in less time than others; can attend to a broader range of activities Written Communications:
Is able to write clearly and succinctly in a variety of communication settings and styles; can get messages across that have the desired effect.
Diversity, Equity, Inclusion & Belonging RiverStone Resources, LLC is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, LGBTQ+, national origin, gender identity, disability, protected veteran status, or any other characteristic protected by law.
Privacy Notice for California Residents https:
//www.
trg.
com/california-consumer-privacy-notice/.
Estimated Salary: $20 to $28 per hour based on qualifications.
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