Claims Consultant, Complex General Liability - Maxum
Location:
Alpharetta , Georgia
Posted:
October 21, 2017
Reference:
1702330
Claim File Management (40%)
  • Plan, recommend, reserve and execute file strategies including investigation, valuation, disposition and settlement of assigned claims, in a manner consistent with corporate claim settlement policies and procedures, and statutory, regulatory and ethics requirements
  • Properly assess the exposure of assigned claims. Plan and organize, establish priorities, anticipate issues, determine realistic completion dates, know and communicate the status of assignments, appropriately manage vendors.
  • Develop advanced functional knowledge to appropriately interpret and apply insurance coverage. Develop technical and jurisdictional expertise.
  • Maintain current knowledge of claim loss cost management initiatives, and utilize them appropriately and in a manner consistent with company practices and procedures
  • Identify and properly mitigation, subrogation, and other recovery opportunities
Customer Service (30%)
  • Maintain dedication to meeting or exceeding expectations and requirements of internal and external customers.
  • Obtain first-hand customer information; use it for improvements in products and services.
  • Establish and maintain effective relationships with customers, gaining their trust and respect. Demonstrate diplomacy and tact to effectively avoid or diffuse high-tension situations.
Business Acumen and Technical Expertise (25%)
  • Utilize verbal and numerical critical thinking skills to gather information, apply sound reasoning and draw appropriate conclusions; make sound decisions based upon mixture of analysis, wisdom experience and judgment.
  • Accurately resolve complex coverage and compensability issues.
  • Possess the ability to investigate, evaluate and negotiate highly complex claims to appropriate disposition
  • Possess superior analytical and critical thinking skills; expert knowledge of complex medical terms, excellent time management abilities
  • Possess the advanced technical knowledge to properly reserve highly complex claims
  • Properly apply statutory laws and regulations of applicable jurisdiction
  • Demonstrate advanced expertise to utilize claim management practices to effectively manage loss costs
  • Expertly contribute to loss cost management by recognizing potential for Subrogation and Special Investigation
Teamwork and Team Building (5%)
  • Support and help create a team environment that achieves diversity and Inclusion initiatives
  • Support and assist in building a high performing team with diverse characteristics, where individual differences are valued
  • Build appropriate rapport and constructive and effective relationships with people inside and outside the organization


Qualifications:
  • College degree preferred or 5 years relevant work experience required
  • Consistent high level of performance and achievement over career span
  • State required certification exams and adjusting licenses
  • SCLA or CPCU designation preferred
  • Demonstrated level of competency as described in Competency Profile
  • Satisfactory completion of the candidate testing/certification process


Equal Opportunity Employer/Females/Minorities/Veterans/Disability/Sexual Orientation/Gender Identity or Expression

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