Claims Specialist II - BI

UFG is looking for a Claims Specialist II - BI to join our team! In this position you will be primarily responsible for investigating, evaluating, negotiating and settling moderate complexity casualty claims. This position is responsible for conducting timely and thorough investigations, verifies applicable coverages, analyzes liability, evaluates damages for reserve and settlement, and negotiates claims to resolution in accordance with claims best practices.

The Claims Specialist II – BI position demonstrates a strong desire to learn and grow, promotes a positive work environment, and buys into a strong service mentality to both internal and external customers.  This position requires strong communication skills, attention to detail, and the ability to handle multiple tasks efficiently and effectively.

Responsibilities: 

• Review new claims assignments to determine the nature of the claim and action required.  
•  Review and interpret applicable policy coverages. If coverage issues are present, draft detailed coverage disclaimer or Reservation of Rights.
• Make prompt, meaningful contact with insureds, claimants, witnesses and other parties of interest.
• Conduct a timely and thorough investigation to identify liability exposures and damages through securing recorded statements, compiling and reviewing investigation reports, medical bills and records, wage loss verification, prior medical history, and securing and reviewing other evidence where the investigation leads you and in accordance with claims best practices.  
• Document all file activity through detailed file notes and prepare reports for the claim file per claims best practice guidelines.
• Evaluate damages and recommend reserves per reserve timeliness and accuracy guidelines.  
•  Develop and execute negotiation strategies and proactively push claims towards resolution.
• Actively identify subrogation potential and posture claim for successful subrogation recovery.   
•  Identify risk transfer opportunities and exposures. Draft tender letters and put all potential parties on notice.
•  Vet, select and retain experts when necessary and approved. Be constantly aware of and apply expense management initiatives.
•  Inform underwriting of increased hazards or unusual circumstances concerning a risk or policy exposure.
• Participate in company sponsored educational programs and other educational opportunities to develop knowledge and skill.
• Participate in various claims committees to drive claims initiatives.

Qualifications:

Education:

• College degree preferred.  

Licensing/Certifications/Designations: 

• Meet the appropriate state licensing requirements to handle claims.
• AIC, SCLA or Legal Principles, CCLA and PCLA of the AEI series, or to be completed in 3 years.

Experience:

•  2  years of casualty claims experience.  

Knowledge:

• Claims best practices.
• Unfair claims practices/bad faith.
• Various lines of policy coverages.
• Applicable laws, regulations and venue.
• Fraud indicators.
• Moderate injuries and impact on case value.
• Basic civil procedure.

Skills & Abilities:

• Ability to read, comprehend and interpret policy language, endorsements, and contracts while applying them to the claim.
• Analytical ability to determine coverage, risk transfer, liability, and bodily injury evaluation for reserves and settlement.
• Negotiation skills, human relations skills, analytical skills, organization skills as well as oral and written communication skills.
• Ability to concisely document information into appropriate file notes and reports.
• Execute speed to settlement strategies.
• Service oriented mindset.
• Clear and Concise communication.
• Analytical and Critical thinking.
• Attitude of Collaboration and Curiosity.
• Proactive Decision-making and Problem-solving.
• Time management and Sense of Service Urgency.

Working Conditions:  

•  Working remote from home or general office environment. 
• Frequently the job requires working irregular hours.
• Occasional overnight travel and weekend hours may be required.

Disclaimer: 

The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this job. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and skills required. Additional tasks and requirements may be assigned, as necessitated by business need. UFG retains the right to modify the description of this job at any time.