Claims Serv Specialist IV

Under minimal supervision investigate and resolve first and third party Material Damage Medical Payment NY PIP and Bodily Injury claims which may involve coverage liability damage and legal issues.

Effort may concentrate around intermediate to large exposure Personal Auto and Personal Umbrella among other market/line combinations.

Provide guidance and direction to legal counsel during the litigation process in order to ensure favorable resolution.

Act as a mentor to new employees to facilitate the on-boarding process.

Key Responsibilities:

• Timely completion of all case activities maximizing customer service and minimizing net loss payout.

• Contacts all insureds claimants and witnesses that may have information relating to the loss either in person by telephone or in writing. This may include visiting the accident location to examine photograph and diagram physical facts and conduct neighborhood canvasses.

• Inputs and retrieves information using the automated claims system requests checks form letters and other correspondence through the automated claim system.

• Evaluates case facts determining coverage liability and reserves and reports on settlement; maintains a reminder system.

• Evaluates case facts confirming coverage and appropriate damages.

• Interprets and evaluates medical reports to determine if they are applicable to the claim; monitors legal and medical billings and investigates for proper charges and pays accordingly.

• Negotiates settlements with individuals attorneys and other insurance carriers within their granted settlement authority level.

• Pursues subrogation and may arrange for salvage to obtain the maximum recovery.

• Prepares detailed scope of damages on property losses and brings to resolution.

• Assists when requested in the selection and evaluation of experts as needed.

• Manages litigation checking to ensure that coverages are not exceeded that legal expenses are adequate and confers with attorney about case direction and disposition.

• Will participate in special projects or training programs.

• Successfully completes all required training and applies.

• Will assist in the training of Claims Service Specialists III and below.

• Will keep management informed of activities and issues within assigned area of responsibility.

• Performs other related duties as required or requested.

Key Requirements:

• Success will be measured based on individual results compared to all established department standards in Customer Service Teamwork Loss and Expense Management as well as Continuous Improvement.

• 3 years of Bodily Injury experience litigation case management preferred.

• Where applicable pass state licensing requirements within first 90 days.

• Valid drivers license in good standing.

• Strong analytical problem-solving and critical thinking.

• Excellent verbal and written communication negotiation.

• High integrity ethics and attention to detail.

• Organizational time management and multitasking.

• Proficient in MS Office applications (Word Excel PPT)

Our current reasonable and good faith estimate of the annual salary wage range for this position is approximately $75000 - $93000 based on a variety of factors including but not limited to relevant skills and experience educational background and certifications performance and qualifications market demand for the role and other organizational needs.

Please note: The advertised pay range is not a guarantee or promise of a specific wage.

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