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Field Claims Specialist

Category

Other

Source

Other

Description

The North Carolina League of Municipalities is initiating the recruitment process for the following position in the Risk Management Services (RMS) unit. The purpose of this position is to oversee and adjust the most complex property and liability claims for members and TPA customers. This is accomplished by investigating and evaluating property and liability claims from members, performing TPA functions, negotiating settlement with members, claimants or their legal representative, directing litigation and defense counsel, and providing other services to the members and TPA customers as needed. Other duties include attending regional RMS workshops and participating in Member events. If you meet the requirements and are interested in being considered for this position, please follow the application process at the link below. 

https://workforcenow.adp.com/jobs/apply/posting.html?client=nclm&jobId=190170&lang=en_US&source=CC2

Field Claims Specialist - PG 007 $64,800-$97,200. Responsibilities/Requirements: Conducts investigations by making phone contact with the member or claimant within 24 hours of receipt of the loss and performing an on-site investigation; obtaining recorded or written statements; identifying possible fraud; and identifying claims that may require assistance of an expert, and providing direction to the expert retained to arrange required services. File inventory includes serious bodily injury and complex litigation. Conducts negotiations and resolutions by settlement negotiations/mediations with member or claimants once coverage/liability/damages have been determined; maintaining a proper reserve; maintains diary and inputs file notes into Claims System timely; providing appropriate closing or settlement documents; and issuing any and all settlement checks. Evaluates damages by reviewing estimates or documentation presented by members and claimants and their legal representative directing independent adjusters or appraisers as a way to substantiate the amount of the claim or loss; reviewing, determining, and calculating the amount of depreciation; requesting full review of medical records; legal theories, analyzing medical bills and records; researching individual diagnosis; analyzing impairment ratings for the injured party; obtaining and reviewing lost wages; identifying and protecting any liens; and posting and maintaining all claim reserves and ensuring reserves are sufficient to reflect the exposure for each claim. Meets with municipal staff and elected officials as needed. Oversees and directs litigation by recognizing the potential for litigation when claim or loss has been denied or settlement negotiations are unsuccessful. Direct assigned attorney and attend important depositions.  Participate in mediations and attend trials/hearings/appeals.  Plan and coordinate legal strategy and assist assigned counsel with case preparation. Provides coverage analysis by determining the nature of claim or loss; reviewing applicable coverage forms or policies; consulting with underwriting; and informing members when coverage does not exist. Prepares Reservation of Rights letters and denial of coverage letters as needed; reads and interprets contracts. Assists supervisor with preparation of reports to reinsurers. Professional development is achieved by attending continuing education courses and seminars; researching and reviewing publications, media reports; providing excellent customer service; providing risk management advice to members; maintaining open communication; traveling to member locations; reviewing  multiple coverage forms; providing needed assistance to City Attorney’s office regarding investigation; assisting TPA customers with development and modification of any denial or recovery correspondence and reporting to excess carrier; and performing additional functions when necessary. Minimum Qualifications: BS/BA degree in business, insurance, or a related field (Master’s degree preferred with specialization in risk management or insurance), or equivalent experience. Over 10 years of progressive claims experience, including the management of complex litigation. Requires excellent written and verbal communication skills and ability to direct messages to and interface with multiple audiences, both externally and internally. Ability to interact at high level of public contact, requiring tact and courtesy. Interpersonal skills to facilitate work with a wide range of individuals and groups from culturally diverse groups. Operate as strategic thinker who excels at coming up with original ideas and is able to execute

Ability to proactively identify risk management member needs, marketing opportunities and develop supporting programs. Strong organizational skills and ability to handle multiple tasks and meet deadlines. Ability to integrate field visits by consulting and marketing staff; able to collaborate with others within an integrated team environment. Significant insurance operations experience that includes a blend of safety, insurance policy analysis, liability loss control, marketing, and risk management programs. Excellent management, organization and leadership skills. Consensus-building across functional-levels and with external/internal stakeholders. Proficiency in marketing by utilizing current technologies such as social media, podcasting, QR codes, and other Internet based solutions. Ability to travel to member locations, including regional sessions, which may require some overnight accommodations. Skills/Certifications/License Required: North Carolina Adjuster's License. FEMA Flood Certification (or ability to obtain). Valid NC Driver License. Proficiency with Word and Excel. This role reports to the Manager of Property and Casualty Claims.  Role can be an office based or home based (within North Carolina) position. Approximately 30 – 40 percent travel is required throughout the state.  League vehicle will be provided and subject to all League and IRS guidelines. Deadline: November 30, 2017 or until filled.

Employer

NC League of Municipalities (NCLM)

Expires

12/15/2017