Established company is seeking for a Senior Claims Rep in the greater Pasadena, CA area on a Direct Hire basis!
Responsibilities:
- Examine, assess, and interpret policy terms, exclusions, and endorsements to determine coverage and liability for assigned claims.
- Draft reservation of rights letters, nonwaiver agreements, and coverage disclaimers to address claim coverage concerns.
- Review and assess claim reserves to ensure they accurately reflect potential exposure.
- Conduct claim investigations to evaluate coverage and legal considerations, which may involve interviewing insured parties and witnesses, gathering statements, records, and other evidence.
- Properly document and report investigative findings and claims handling activities.
- Negotiate and resolve claims through mediation, arbitration, or court-supervised settlements, working with claimants, insured parties, and their legal representatives while preparing necessary resolution documents.
- Stay informed on regulatory and jurisdictional requirements.
- Oversee and provide guidance to defense counsel, independent adjusters, and other third parties engaged in claim resolution.
- Identify and pursue risk transfer opportunities when applicable.
- Perform additional duties as assigned.
Requirements
- At least five years of experience in the following areas:
- Coverage Review - Interpreting policies, agreements/contracts, reservation of rights, and disclaimers.
- Claims Investigation - Conducting interviews, obtaining statements and authorizations, and coordinating with qualified experts and legal counsel.
- Claims Administration - Preparing reports, reviewing reserves, and ensuring compliance with relevant laws and procedures.
- Claims Settlement - Drafting disclaimer letters, releases, and proof of loss statements, and participating in legal proceedings as necessary.
- Strong knowledge of coverage principles, negligence laws, investigative techniques, and negotiation strategies.
- Ability to obtain and maintain state adjusting licenses as required.
- Service-oriented approach with a commitment to providing prompt, efficient, and effective claims and customer service.
- Excellent communication skills for interacting with customers, claimants, opposing and defense counsel, and the public.
- Strong organizational skills with the ability to manage multiple tasks simultaneously.
- Exceptional judgment, negotiation, and decision-making abilities.
- Must be able to travel between various off-site locations or for overnight stays as needed.
- Experience handling liability claims in western states, including Montana, Wyoming, Colorado, New Mexico, Idaho, Utah, Arizona, California, Washington, and Oregon.
All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance. For unincorporated Los Angeles county, to the extent our customers require a background check for certain positions, the Company faces a significant risk to its business operations and business reputation unless a review of criminal history is conducted for those specific job positions.
