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Complex Claims Specialist III - D&O And Financial Institutions E&O
Location
United States
Posted
39 days ago
Salary
$38 - $53 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Complex Claims Specialist III - D&O And Financial Institutions E&O
TEKsystems
Role Description - Draft coverage letters which will have a secondary review. - File documentation and requirements. - Severity complex line, claims can be very complex. - Manages an inventory of the complex Public D&O and Financial Institutions E&O claims, which are generally multi-year and have significant loss exposure, by following company protocols to manage and oversee all aspects of the claim handling, including: - Coverage determinations. - Investigations. - Resolution strategies which may include pursuit of risk transfer, extensive negotiations, and complex litigation management. - Ensures exceptional customer service by driving continuous improvements for all aspects of the claim/account, providing professional and timely claims services, and achieving quality and cycle time standards. - Verifies coverage, sets and manages timely and adequate reserves by: - Reviewing and interpreting policy language. - Partnering with coverage counsel as needed. - Estimating potential claim valuation. - Following company's claim handling protocols. - Leads all activities involved with a focused investigation to determine compensability, liability, and covered damages by: - Gathering pertinent information. - Documenting statements from customers/claimants. - Working with experts or other parties as necessary to verify the facts of the claim. - Drives the resolution of claims by collaborating with internal and external business partners to develop, own, and execute a claim resolution strategy, including: - Management of timely and adequate reserves. - Collaborating with coverage experts. - Negotiating complex settlements. - Partnering with counsel to manage complex litigation. - Authorizing payments within scope of authority. - Establishes and manages significant claim budgets by: - Identifying, selecting, and actively managing appropriate resources. - Delivering high quality services. - Coordinating all efforts leading to timely resolution of the claim/accounts. - Discovers and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making appropriate referrals to Claim, Recovery, or SIU resources for further investigation. - Achieves quality standards by effectively managing each claim to ensure that: - All company protocols are followed. - Work is accurate and timely. - All files are properly documented. - Claims are resolved and paid timely. - Prepares and presents high profile, complex information to senior leadership, customers, counsel, and others by: - Identifying high profile matters. - Developing executive loss summaries. - Coordinating and communicating resolution strategies. - Sharing relevant current events and case law. - Maintains subject matter expertise and ensures compliance with state/local regulatory requirements by: - Following company guidelines. - Staying current on insurance laws, regulations, or trends for the specialized line of business. - Representing the company in industry trade groups or other important events. - May assist with special projects as needed. - May perform additional duties as assigned. Qualifications - Expert knowledge of specialty insurance industry, products, policy language, coverage, and claim practices. - Excellent verbal and written communication skills with the ability to develop collaborative working relationships. - Demonstrated analytical and investigative mindset with critical thinking skills. - Extensive experience in leading complex negotiations and developing resolution strategies. - Strong work ethic with demonstrated time management and organizational skills. - Ability to drive results by taking a proactive long-term view of business goals and objectives. - Extensive experience interpreting D&O and E&O insurance policies and coverage. - Ability to partner with internal resources and manage outside counsel. - Ability to lead multiple and shifting priorities in a fast-paced environment. - Knowledge of Microsoft Office Suite and ability to learn business-related software. - Demonstrated ability to value diverse opinions and ideas. Requirements - This is a Contract position based out of Dallas, TX. - The pay range for this position is $38.46 - $52.88/hr. Benefits - Medical, dental & vision. - Critical Illness, Accident, and Hospital. - 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available. - Life Insurance (Voluntary Life & AD&D for the employee and dependents). - Short and long-term disability. - Health Spending Account (HSA). - Transportation benefits. - Employee Assistance Program. - Time Off/Leave (PTO, Vacation or Sick Leave). Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Jun 19, 2026.
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