Associate Specialty Claims Consultant

Job Description:

• The Assoc Consultant Specialized Claims is responsible for managing moderately complex specialized claims with minimal supervision.
• This is an introductory role that will be responsible for the handling of Miscellaneous Professional Liability and Supplemental Coverage matters under other Professional Liability forms, such as Accountants, Lawyers, and Architects/Engineers.
• This role requires moderately complex investigative, coverage analysis, and negotiation skills to effectively resolve disputes and support high-quality claim outcomes.
• The Assoc Consultant works closely with internal stakeholders and external experts, including legal counsel, to ensure thorough evaluation and resolution of claims.
• Key responsibilities include maintaining a high standard of professionalism, ensuring compliance with regulatory and company standards, and applying sound judgment in navigating sensitive and high-impact claim scenarios.
• The role offers opportunities to deepen technical expertise in specialized lines of business while contributing to the overall success of the claims organization.

• Independently manage Supplemental Coverage matters such as subpoenas, disciplinary proceedings, excess matters, notice only matters, and other claims, as assigned, within the Professional Liability coverage area. Lead thorough investigations, assess coverage, and issue appropriate documentation including reservation of rights and coverage letters. Escalate issues as needed.
• Identify and proactively pursue opportunities to transfer risk to the appropriate entities for the benefit of insureds and business partners.
• Maintain comprehensive and detailed claim records, including complex and high-value claims.
• Ensure all claims activities comply with regulatory and company standards. Maintain accurate, detailed records and prepare comprehensive reports. Execute jurisdictional compliance requirements and support others in understanding regulatory obligations.
• Set reserves, authorize payments, and make financial decisions within authority. Demonstrate strong financial acumen and contribute to reserving accuracy and efficiency.
• Coordinate with internal and external stakeholders including legal, underwriting, vendors, and agents. Lead cross-functional meetings and communicate complex information clearly to diverse audiences.
• Use advanced tools and analytics to identify trends, correct inconsistencies, and improve claims handling efficiency. Ensure proper data ingestion, labeling, and protection of personally identifiable information (PII).
• Adhere to claimant's preferred communication methods (e.g., email, text, phone).
• Accurately represent policyholder and third-party claimant information in all communications and documentation. Work collaboratively with team members to gather information and complete basic claim tasks.
• Participate in team meetings and contribute to discussions regarding claim status and issues.
• Manage possible suspicious claims, using advanced techniques and tools and refer them to the Special Investigation Unit as needed.
• Identify and assign Subro potential appropriately; set up file to support successful recovery.
• Ensure compliance with all licensing requirements. Essential Skills and Experience:
• Bachelor's degree or equivalent experience with claims handling. Typically requires 2 5 years of liability claims handling experience.
• Skilled in negotiating claims and developing strategies to influence outcomes. Demonstrates sound judgment and decision-making on moderately complex cases.
• Communicates clearly and effectively in both verbal and written formats across a variety of situations. Selects appropriate communication channels and consistently demonstrates empathy toward all stakeholders.
• Drafts relevant, factual, and objective work products. Maintains comprehensive and organized claim records and prepares detailed reports summarizing findings and recommendations.
• Highly organized with the ability to manage complex workflows and participate in project work. Demonstrates strong time management and desk management skills, and mentors others in these areas.
• Provide large loss and reinsurance reporting as needed.
• Makes informed decisions based on thorough analysis of complex issues. Evaluates risks and outcomes, acts independently within authority, and identifies patterns in claims to support resolution strategies.
• Skilled in investigating complex cases and collaborating with internal and external experts. Coordinates closely with legal, underwriting, and other stakeholders to ensure thorough evaluation.
• Maximize litigation process for optimal claim outcome.
• Proficient with advanced computer navigation. Able to use basic software systems/applications (Suite of MS Office Products) and internet resources.
• Draft relevant, factual, and appropriate work product without opinion.
• Adapts easily to changing priorities, fosters a collaborative team environment, and exercises sound judgment with autonomy in decision-making.
• Commitment to ongoing professional development.

• Analytical Reasoning: The ability to identify problems, understand your impact, gather input and data, and develop an effective solution.
• Customer Centricity: Makes customers/clients and their needs a primary focus of one's actions; shows interest in and understanding of the needs and expectations of internal and external customers; gains customer trust and respect; meets or exceeds customer expectations.
• Digital Fluency: Effectively uses digital tools and technology appropriately to find, evaluate, create, and communicate information understands how to navigate digital platforms, use software applications, and leverage technology for productivity and communication purposes.
• Persuasion and Influence: Uses appropriate interpersonal skills and techniques to gain acceptance for ideas or solutions; uses influencing strategies to gain genuine agreements; seeks to persuade rather than force solutions or impose decisions or regulations.
• Professional Insurance Acumen: Demonstrates a deepening understanding of the insurance industry and the ability to apply specialized technical skills to address complex challenges, adapt to industry trends, and drive value for the organization.
• Planning and Execution: Plans, prioritizes and manages resources and time effectively to achieve specific goals or deadlines.

• Ability to use a personal computer and other standard office equipment
• Ability to sit and/or stand for extended periods
• Required to work on-site as needed
• Ability to travel as necessary
• Ability to work in a fast paced, changing or stressful environment
• Ability to perform work in a noisy/loud work environment
• May be required to have and maintain sufficient home-based internet connection