Analyze complex or technically difficult general liability claims to determine benefits due
Work with high exposure claims involving litigation and rehabilitation
Ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements
Identify subrogation of claims and negotiate settlements
Manage claims through well-developed action plans to an appropriate and timely resolution
Assess liability and resolve claims within evaluation
Negotiate settlement of claims within designated authority
Calculate and assign timely and appropriate reserves to claims
Manage reserve adequacy throughout the life of the claim
Calculate and pay benefits due and approve claim payments and adjustments
Prepare necessary state filings within statutory limits
Manage the litigation process to ensure timely and cost-effective claims resolution
Coordinate vendor referrals for additional investigation and/or litigation management
Use appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients
Manage claim recoveries including subrogation and Social Security and Medicare offsets
Communicate claim activity and processing with the claimant and the client

Bachelor's degree from an accredited college or university preferred.
Professional certification as applicable to line of business preferred.
Five (5) years of claims management experience or equivalent combination of education and experience required.
Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Good interpersonal skills
Excellent negotiation skills
Ability to work in a team environment
Ability to meet or exceed Service Expectations

Claims Examiner, Liability

Key skills