Complex Casualty Claims Specialist - Mid Atlantic Region

Join Our Team as a Senior Claims Resolution Specialist – Mid Atlantic Region

Are you ready to take your claims expertise to the next level? Personal Lines Casualty Complex is seeking a dedicated and experienced Senior Claims Resolution Specialist to lead the handling of challenging auto and homeowner’s casualty claims across our Mid Atlantic Region.

In this pivotal role, you’ll take ownership of complex, high-exposure cases, diving deep into investigations, evaluations, and strategic resolutions.  This is your opportunity to make a real impact, handling severe and catastrophic injury claims that demand both skill and compassion. If you thrive in a fast-paced environment where your expertise drives meaningful outcomes, we want to hear from you!

This position is eligible for up to a $2,500 sign on bonus after 90 days of employment for external candidates with an active All-Lines Adjuster license in Florida or Texas (will need to provide documentation of active license and all CE’s must be completed).

Preference for candidates who reside within Eastern or Central Time Zones. 

There is an in-office requirement twice a month if you live within 50 miles of one of our Hub locations.

10% travel may be required for mediations, arbitrations, trials and in-person events.

Training is a critical component to your success and that success starts with reliable attendance. Attendance and active engagement during training is mandatory.

Responsibilities:

• Manages, investigates, and resolves auto and homeowner’s casualty claims. Investigates and evaluates coverage, liability, damages, and settles claims within prescribed procedures and authority. Recommends ultimate resolution on assigned cases in excess of their authority to local claims management and Home Office.
• Identifies potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation.
• Prepares for and attends trials, hearings and conferences and reports to Home Office and local management on status.
• Confers with trial counsel and prepares trial reports.
• Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to proper course of action.
• Responds to various written and telephone inquiries including status reports.
• Ensures adequacy of reserves. Recommends reserve increases on cases in excess of authority.
• Accountable for security of financial processing of claims, as well as security information contained in claims files.
• Responsible for managing the practices and billing activities of outside and in-house counsel.
• May assist in the absence of the Claims Team Manager, representing the company on matters involving state or federal regulatory agencies.
• May be involved in special projects and/or mentoring at the direction of local management.

Preferred Qualifications: 

• 5+ years of litigation experience
• Expert knowledge of handling personal lines complex claims with severe to catastrophic injuries and fatalities 

• Must have an expert knowledge of coverage, liability, and complex claims handling procedures.
• Must be able to effectively handle claims at the highest technical and complexity level.
• Must be knowledgeable of state and federal laws in the adjuster's jurisdiction.
• A full working knowledge of claims operations and procedures is required.
• Excellent written and oral communications skills required as well as strong interpersonal, analytical, investigative and negotiation skills.
• The capabilities, skills and knowledge required is normally acquired through a Bachelor's degree or equivalent experience and at least 7 years of directly related experience.
• Ability to obtain proper licensing as required.