Major Case Specialist, Construction Defect - Charlotte NC
VetJobs, Charlotte, NC, United States
Eligible applicants include Veterans, transitioning military, National Guard and Reserve members, military spouses, wounded warriors, and their caregivers.
What Is the Opportunity?
This role offers a sign‑on bonus up to $20,000 and an annual base salary ranging from $104,000 to $171,700.
What Will You Do?
Claim Handling
Investigate, evaluate, reserve, negotiate and resolve severe and complex construction defect and property damage claims.
Provide quality claim handling throughout the claim life cycle: customer contact, coverage analysis, investigation, reserving, litigation management, negotiation, and resolution.
Maintain full compliance with internal and external quality standards and state‑specific regulations.
Serve as a consulting and training resource to claim professionals, business partners, and other stakeholders.
Provide quality customer service and ensure file quality, timely coverage analysis and communication with insureds.
Work with the manager on the use of Claim Coverage Counsel as needed.
Directly investigate each claim through prompt and strategically appropriate contact with parties such as policyholders, account managers, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts.
Interview witnesses and stakeholders; take necessary statements as strategically appropriate.
Complete outside investigation as needed per case specifics.
Actively engage in identifying, selecting and directing appropriate internal and/or external resources (subrogation, risk control, nurse consultants, fire or fraud investigators, and other experts).
Verify the nature and extent of injury or property damage by obtaining and reviewing appropriate records and documents.
Maintain claim files and document claim file activities in accordance with established procedures.
Develop and employ creative resolution strategies.
Ensure prompt and proper disposition of all claims within delegated authority.
Negotiate disposition of claims with insureds and claimants or their legal representatives.
Recognize and implement alternate means of resolution.
Manage litigated claims and develop litigation plans with staff or panel counsel, including discovery and legal expenses.
Utilize evaluation documentation tools in accordance with department guidelines.
Proactively review Claim File Analysis (CFA) for adherence to quality standards and trend analysis.
Use diary management system to ensure all claims are handled timely and evaluate liability and damages exposure at required intervals.
Establish and maintain proper indemnity and expense reserves.
Communications / Influence
Provide guidance to underwriting business partners regarding accuracy and adequacy of loss reserves on assigned claims.
Recommend appropriate cases for discussion at roundtables.
Attend and/or present at roundtables or authority discussions to collaborate technical expertise and improve payout on indemnity and expense.
Share experience and knowledge of creative resolution techniques to improve claim results of others.
Apply the company’s claim quality management protocols and metrics to all claims.
Document the rationale for any departure from applicable protocols and metrics with or without assistance.
Other Accountabilities
Apply litigation management through selection of counsel and evaluation.
Perform other duties as assigned.
Potential for travel up to 30%.
Additional Qualifications / Responsibilities
Bachelor’s degree.
10+ years of claim handling experience with 5-7 years of experience handling serious injury and complex liability claims.
Extensive working level knowledge and skill in various business line products.
Excellent negotiation and customer service skills.
Advanced skills in coverage, liability and damages analysis; expert understanding of litigation process in both state and federal courts.
Extensive claim and/or legal experience providing technical expertise to evaluate severe and complex claims.
Ability to make independent decisions on most assigned cases without supervisor involvement.
Openness to the ideas and expertise of others; actively solicits input and shares ideas.
Thorough understanding of commercial lines products, policy language, exclusions, ISO forms and effective claims handling practices.
Demonstrated strong coaching, influence and persuasion skills.
Advanced written and verbal communication skills to synthesize and convey complex data.
Adaptability to support cultural change.
Strong technology aptitude; ability to use business technology tools effectively.
Analytical thinking – Advanced.
Judgment / Decision Making – Advanced.
Communication – Advanced.
Negotiation – Advanced.
Insurance Contract Knowledge – Advanced.
Principles of Investigation – Advanced.
Value Determination – Advanced.
Settlement Techniques – Advanced.
Litigation Management – Advanced.
Medical Terminology and Procedural Knowledge – Advanced.
Must Have
10+ years of claim handling experience or related experience with 3-5 years of experience handling serious injury and complex liability claims.
High school degree or GED required; acquisition and maintenance of Property/Causalty Adjuster License(s) may be required to comply with state and Travelers requirements.
License(s) are required to be obtained within three months of starting the job.
Location: Charlotte, North Carolina.
#J-18808-Ljbffr
What Is the Opportunity?
This role offers a sign‑on bonus up to $20,000 and an annual base salary ranging from $104,000 to $171,700.
What Will You Do?
Claim Handling
Investigate, evaluate, reserve, negotiate and resolve severe and complex construction defect and property damage claims.
Provide quality claim handling throughout the claim life cycle: customer contact, coverage analysis, investigation, reserving, litigation management, negotiation, and resolution.
Maintain full compliance with internal and external quality standards and state‑specific regulations.
Serve as a consulting and training resource to claim professionals, business partners, and other stakeholders.
Provide quality customer service and ensure file quality, timely coverage analysis and communication with insureds.
Work with the manager on the use of Claim Coverage Counsel as needed.
Directly investigate each claim through prompt and strategically appropriate contact with parties such as policyholders, account managers, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts.
Interview witnesses and stakeholders; take necessary statements as strategically appropriate.
Complete outside investigation as needed per case specifics.
Actively engage in identifying, selecting and directing appropriate internal and/or external resources (subrogation, risk control, nurse consultants, fire or fraud investigators, and other experts).
Verify the nature and extent of injury or property damage by obtaining and reviewing appropriate records and documents.
Maintain claim files and document claim file activities in accordance with established procedures.
Develop and employ creative resolution strategies.
Ensure prompt and proper disposition of all claims within delegated authority.
Negotiate disposition of claims with insureds and claimants or their legal representatives.
Recognize and implement alternate means of resolution.
Manage litigated claims and develop litigation plans with staff or panel counsel, including discovery and legal expenses.
Utilize evaluation documentation tools in accordance with department guidelines.
Proactively review Claim File Analysis (CFA) for adherence to quality standards and trend analysis.
Use diary management system to ensure all claims are handled timely and evaluate liability and damages exposure at required intervals.
Establish and maintain proper indemnity and expense reserves.
Communications / Influence
Provide guidance to underwriting business partners regarding accuracy and adequacy of loss reserves on assigned claims.
Recommend appropriate cases for discussion at roundtables.
Attend and/or present at roundtables or authority discussions to collaborate technical expertise and improve payout on indemnity and expense.
Share experience and knowledge of creative resolution techniques to improve claim results of others.
Apply the company’s claim quality management protocols and metrics to all claims.
Document the rationale for any departure from applicable protocols and metrics with or without assistance.
Other Accountabilities
Apply litigation management through selection of counsel and evaluation.
Perform other duties as assigned.
Potential for travel up to 30%.
Additional Qualifications / Responsibilities
Bachelor’s degree.
10+ years of claim handling experience with 5-7 years of experience handling serious injury and complex liability claims.
Extensive working level knowledge and skill in various business line products.
Excellent negotiation and customer service skills.
Advanced skills in coverage, liability and damages analysis; expert understanding of litigation process in both state and federal courts.
Extensive claim and/or legal experience providing technical expertise to evaluate severe and complex claims.
Ability to make independent decisions on most assigned cases without supervisor involvement.
Openness to the ideas and expertise of others; actively solicits input and shares ideas.
Thorough understanding of commercial lines products, policy language, exclusions, ISO forms and effective claims handling practices.
Demonstrated strong coaching, influence and persuasion skills.
Advanced written and verbal communication skills to synthesize and convey complex data.
Adaptability to support cultural change.
Strong technology aptitude; ability to use business technology tools effectively.
Analytical thinking – Advanced.
Judgment / Decision Making – Advanced.
Communication – Advanced.
Negotiation – Advanced.
Insurance Contract Knowledge – Advanced.
Principles of Investigation – Advanced.
Value Determination – Advanced.
Settlement Techniques – Advanced.
Litigation Management – Advanced.
Medical Terminology and Procedural Knowledge – Advanced.
Must Have
10+ years of claim handling experience or related experience with 3-5 years of experience handling serious injury and complex liability claims.
High school degree or GED required; acquisition and maintenance of Property/Causalty Adjuster License(s) may be required to comply with state and Travelers requirements.
License(s) are required to be obtained within three months of starting the job.
Location: Charlotte, North Carolina.
#J-18808-Ljbffr