Commercial Claims Specialist

JOB OBJECTIVE:

The Commercial Claims Specialist primarily investigates, evaluates and processes commercial claims which includes complicated coverage issues.

ESSENTIAL FUNCTIONS:

• Handle commercial general liability claims which includes but not limited to construction defects, third party injuries, and acts, errors and omissions claims.
• Handle mechanical professional liability damage claims in conjunction with damage appraisers and outside experts.
• Handle third party property damage claims in conjunction with property resolution specialists.
• Coordinate inspections with outside vendors including but not limited to cause and origin experts and engineers.
• Provide limited handling for commercial lines lawsuits as requested.
• Comply with the claims organization's policies, established best practices and jurisdictional guidelines.
• Comply with practices and procedures for contact and communication, verification of coverages, determination of liability, investigation of losses, and determination of claims values, completion of forms and reports, and negotiation and settlement of claims.
• Comply with all state unfair claims practices acts and obtain state licensing as required.
• Maintain competency in the use of the claims system and manage efficient and effective follow-up practices.
• Effectively investigate and close a minimum average of 25 losses per month.

OTHER FUNCTIONS:

• Maintain an ongoing understanding of claims processes, procedures and systems, and keep current on fair claims practices laws, compliance issues, and business-related developments.
• Make limited outside contacts at the discretion of the manager of commercial claims.
• Perform other duties as assigned.

KNOWLEDGE, SKILLS AND ABILITIES:

• This position requires a minimum of 5 years' experience as a claims resolution specialist or related industry experience.
• The candidate must have demonstrated excellent telephone and personal claims negotiation and investigation skills.
• The individual must understand tort law and possess strong knowledge of medical terms and treatments and display good judgement in their decision making.
• An excellent knowledge of commercial lines policies and coverages is required.
• The candidate must understand auto and building repair methods and be able to analyze both if required in their specific job duties.
• The individual should actively demonstrate the skills and abilities listed in the claims resolution specialist job description.
• Continuing Education is preferred and may be obtained through the following: In-house Claims Training Classes, The Institutes (Associate in Claims (AIC) and/or Chartered Property Casualty Underwriter (CPCU) designations) or other accredited insurance education provider.
• A college degree is strongly desired and multi-language skills a plus.

This position has been evaluated in accordance with the Americans with Disabilities Act. Encova Insurance makes every effort to reasonably accommodate disabilities to permit performance of the essential functions and candidates who need such accommodation are encouraged to seek it. This description reflects the nature and level of work performed by associates in this position. It is not an all-inclusive inventory of duties, responsibilities and qualifications required. It provides an accurate overview of the work and skills needed to perform this position. Because job content may change from time to time, Encova Insurance reserves the right to add and/or delete functions from this job as it deems necessary for business reasons.