Major Case Specialist, Construction Defect - Blue Bell PA
VetJobs, Whitpain Hills, PA, United States
Job Description
Our organization works with partner companies to source qualified talent for their open roles. This position is open to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. The role involves investigating, evaluating, reserving, negotiating and resolving assigned serious and complex Construction Defect and Property Damage claims. Responsibilities include handling full claim lifecycle, maintaining quality, compliance, consulting, training, and liaising with stakeholders.
Responsibilities
Directly handle assigned severe claims, with average damage value ranging from $500,000 to several million dollars.
Provide quality customer service and ensure timely coverage analysis and communication with insured parties.
Investigate claims through contact with policyholders, claimants, investigators, witnesses, agents, medical providers, and technical experts to determine liability, damages and contribution potential.
Interview witnesses and stakeholders; take statements as appropriate.
Conduct outside investigations as needed.
Engage internal and external resources such as subrogation, risk control, nurse consultants, fire or fraud investigators, and other experts.
Verify nature and extent of injury or property damage via records and documentation.
Maintain claim files and document all activities in accordance with procedures.
Develop and employ creative resolution strategies.
Promptly disposition all claims within delegated authority.
Negotiate claim disposition with insureds, claimants, or their legal representatives.
Implement alternate means of resolution, such as mediation or settlement.
Manage litigated claims by developing litigation plans, handling discovery and legal expenses, and ensuring effective resolution.
Use evaluation documentation tools per department guidelines.
Review Claim File Analysis for quality standards and trend analysis.
Utilize diary management system to ensure timely handling of all claims.
Evaluate liability and damages exposure at required intervals.
Establish and maintain proper indemnity and expense reserves.
Provide guidance to underwriting partners on accuracy and adequacy of loss reserves.
Recommend cases for roundtable discussions and present technical expertise to improve payouts.
Share experience and knowledge of creative resolution techniques to improve claim results of others.
Apply company claim quality management protocols and metrics.
Perform additional duties as assigned.
Potential for travel up to 30%.
Qualifications
Bachelor's Degree (minimum).
10+ years of claim handling experience with 5-7 years of experience handling serious injury and complex liability claims.
Extensive knowledge of various business line products.
Excellent negotiation and customer service skills.
Advanced coverage, liability, and damages analysis skills and expert understanding of litigation processes.
Extensive claim and/or legal experience and technical expertise to evaluate severe and complex claims.
Ability to make independent decisions on most cases without supervisor involvement.
Openness to collaboration and active solicitation of input.
Thorough understanding of commercial lines products, policy language, exclusions, ISO forms, and effective claims handling practices.
Strong coaching, influence, and persuasion skills.
Advanced written and verbal communication skills.
Adaptability to cultural change.
Strong technology aptitude.
Advanced analytical thinking, judgment/decision making, negotiation, insurance contract knowledge, principles of investigation, value determination, settlement techniques, litigation management, medical terminology.
High school diploma or GED required.
Property/Casualty Adjuster License(s) may be required; licenses usually obtained within three months of starting the job.
Preferred Qualifications
10+ years of claim handling experience with 5-7 years of serious injury and complex liability claims.
High school diploma or GED.
Ability to obtain adjuster licenses within three months of starting.
Compensation
Annual base salary range: $104,000.00 – $171,700.00. Sign‑on bonus up to $20,000. Eligible for performance‑based cash incentive awards.
Location
Blue Bell, Pennsylvania.
Additional Information
Auto req ID: 470372BR.
#J-18808-Ljbffr
Our organization works with partner companies to source qualified talent for their open roles. This position is open to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. The role involves investigating, evaluating, reserving, negotiating and resolving assigned serious and complex Construction Defect and Property Damage claims. Responsibilities include handling full claim lifecycle, maintaining quality, compliance, consulting, training, and liaising with stakeholders.
Responsibilities
Directly handle assigned severe claims, with average damage value ranging from $500,000 to several million dollars.
Provide quality customer service and ensure timely coverage analysis and communication with insured parties.
Investigate claims through contact with policyholders, claimants, investigators, witnesses, agents, medical providers, and technical experts to determine liability, damages and contribution potential.
Interview witnesses and stakeholders; take statements as appropriate.
Conduct outside investigations as needed.
Engage internal and external resources such as subrogation, risk control, nurse consultants, fire or fraud investigators, and other experts.
Verify nature and extent of injury or property damage via records and documentation.
Maintain claim files and document all activities in accordance with procedures.
Develop and employ creative resolution strategies.
Promptly disposition all claims within delegated authority.
Negotiate claim disposition with insureds, claimants, or their legal representatives.
Implement alternate means of resolution, such as mediation or settlement.
Manage litigated claims by developing litigation plans, handling discovery and legal expenses, and ensuring effective resolution.
Use evaluation documentation tools per department guidelines.
Review Claim File Analysis for quality standards and trend analysis.
Utilize diary management system to ensure timely handling of all claims.
Evaluate liability and damages exposure at required intervals.
Establish and maintain proper indemnity and expense reserves.
Provide guidance to underwriting partners on accuracy and adequacy of loss reserves.
Recommend cases for roundtable discussions and present technical expertise to improve payouts.
Share experience and knowledge of creative resolution techniques to improve claim results of others.
Apply company claim quality management protocols and metrics.
Perform additional duties as assigned.
Potential for travel up to 30%.
Qualifications
Bachelor's Degree (minimum).
10+ years of claim handling experience with 5-7 years of experience handling serious injury and complex liability claims.
Extensive knowledge of various business line products.
Excellent negotiation and customer service skills.
Advanced coverage, liability, and damages analysis skills and expert understanding of litigation processes.
Extensive claim and/or legal experience and technical expertise to evaluate severe and complex claims.
Ability to make independent decisions on most cases without supervisor involvement.
Openness to collaboration and active solicitation of input.
Thorough understanding of commercial lines products, policy language, exclusions, ISO forms, and effective claims handling practices.
Strong coaching, influence, and persuasion skills.
Advanced written and verbal communication skills.
Adaptability to cultural change.
Strong technology aptitude.
Advanced analytical thinking, judgment/decision making, negotiation, insurance contract knowledge, principles of investigation, value determination, settlement techniques, litigation management, medical terminology.
High school diploma or GED required.
Property/Casualty Adjuster License(s) may be required; licenses usually obtained within three months of starting the job.
Preferred Qualifications
10+ years of claim handling experience with 5-7 years of serious injury and complex liability claims.
High school diploma or GED.
Ability to obtain adjuster licenses within three months of starting.
Compensation
Annual base salary range: $104,000.00 – $171,700.00. Sign‑on bonus up to $20,000. Eligible for performance‑based cash incentive awards.
Location
Blue Bell, Pennsylvania.
Additional Information
Auto req ID: 470372BR.
#J-18808-Ljbffr