Commercial Auto Claims Specialist
Remote Position with Domicile Preference: Western States (CA, TX)
Competitive compensation and benefit package including health, dental, vision, life insurance, 401k plan with match.
Who We Are:
Certus Claims is a growing third-party administrator (TPA) managing commercial auto, general liability and property claims for insurance carriers including but not limited to those within the Construction, Hospitality, and Habitational industries. We are currently seeking a dynamic individual to join Certus as a Commercial Auto Claims Specialist with in-depth commercial auto experience. Multi-line claims handling experience is desirable.
Job Description:
The Claims Specialist will:
Investigate all aspects of assigned claims from cradle to grave including coverage determination, resolving informally postured claims directly, working with defense counsel where defense obligation exists, issuing reservation of rights letters where coverage does exist, issuing coverage declinations when coverage does not exist, negotiating covered claims to resolution, responding to push backs or rebuttals if received.
Handle claims within Intercompany Arbitration protocol
Comply with all statutory and regulatory requirements in all applicable jurisdictions.
Work with assigned vendor to complete vehicle inspections, obtain written estimates, negotiate repair process, determine total loss evaluations, and set clear expectations and timelines
Document information related to the claim and make decisions consistent with claims standards and local laws
Evaluate and handle claim payments and resolution of claims without payments
Review and determine validity of any supplement requests
Thoroughly investigate, review information/documentation received, identify key issues and plan of action required, conduct a thorough analysis of liability and damages, and input and review notes/diaries into claims management system.
Ability to guide and control litigation with an eye towards early resolution.
Attend and participate in mandated case or claim-related events including court, mediation and arbitration proceedings.
Manage non-litigated, litigated and coverage files within industry and client guidelines.
Select and manage defense and coverage counsel, investigators, field adjusters, vendors and expert witnesses within company and/or client guidelines, and ensure that company resources with regard to same are utilized in a cost effect manner in the process.
Determine if subrogation opportunity exists and takes steps to initiate recovery efforts.
Follow client-specific requirements for reporting, vendor assignment, reserve and settlement authority and control loss adjustment expenses.
Handle complex litigated and non-litigated commercial auto claims across the United States. This would include investigating, evaluating, and resolving claims and lawsuits of a more severe and complex nature.
You Are Someone with:
Self-direction, self-motivation, independent and analytical thinking skills
Familiarization with state insurance regulations for all 50 states but predominantly handling claims in Western states, including California, Arizona, Nevada, and Utah.
Occasional air travel may be required
Superior track record in all aspects of claims handling and resolution. Strong coverage and negotiation skills a must
Strong collaboration skills to work with internal and external team members in driving the claims process
Self-starter with the ability to drive work streams and analyses
Ability to work in a fast-paced environment and under pressure
Strong working knowledge of Microsoft Office suite of products including Outlook, Word, Excel and Power Point
Strong communication (written/verbal) and presentation skills
Home state licensing required
5-7 years or more experience preferred
Advanced litigation management skills
Ability to be licensed and bonded for state insurance licenses as needed
Multiline claims handling experience is desirable
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