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Arch Insurance Group Inc. · 3 hours ago

Sr. Complex Claims Examiner, Major Case Unit

New Jersey, United States

Full-time

Hybrid

Senior Level, Lead/Staff

$145K/yr - $160K/yr

10+ years exp

Arch Insurance Group Inc. is a company dedicated to promoting progress and inspiring clients through collaboration and innovation. The Sr. Complex Claims Examiner will manage large exposure and complex general/auto liability claims, ensuring effective communication and collaboration with various stakeholders to achieve optimal claim outcomes.

FinanceFinancial ServicesInsurance

Responsibilities

Deliver industry leading technical claim handling/oversight, claim outcomes, business support and customer service. Make claim services an Arch competitive advantage

Collaborate with TPA team members, Arch Claim Account Managers (“CAM’s”) and other claim professionals to proactively develop and effectively execute on appropriate claim resolution strategies

Work closely with underwriters, Legal, Operations, claim professionals, and other Arch functions, to ensure timely and effective communication consistent with Arch Claims’ Procedures, striving to achieve optimum claim outcomes

Effective and timely communication with insureds and brokers; making exceptional customer service a top priority

Coverage analysis, investigation, liability and damage evaluation, timely and accurate indemnity and expense reserving (within specific granted authority), litigation management, vendor management, settlement negotiations, including use of structure settlements where appropriate, and claim resolution

Effective claim file documentation, claim coding and diary management

Retain and work closely with defense and coverage counsel to create and execute on litigation/coverage strategies and budgets. Analyze and pay legal bills, consistent with claims specific strategy/budget and Arch Claims Litigation Management Guidelines

Effective and timely claim reporting (verbal and written) to other claim professionals/management and business stakeholders, per Arch Claims Procedures

Attend mediations, trials, other proceedings and meetings

Maintains all required state adjustor licenses

Assist CAM’s and others with TPA management and oversight to include:

TPA claim staff training relating to Arch processes, procedures, expectations, reporting, technical claim handling, litigation/vendor management, legal/regulatory developments, customer service and other topics that may arise

Sharing of claim handling/customer service best practices

Assistance with claim file reviews and claim audits

Regular meetings with TPA claims staff

Qualification

Complex claims handlingTPA managementNegotiation skillsCustomer serviceAnalytical skillsCommunication skillsMicrosoft ExcelMicrosoft PowerPointMicrosoft WordCollaboration skillsProblem-solving skillsInterpersonal skillsAdaptability

Required

Bachelor's degree required

Minimum of 10 years commercial general/auto liability claim handling experience, including responsibility for complex and large exposure claims, or insurance defense/coverage practicing attorney with similar law firm experience

Excellent customer service skills and service minded

Strong analytical and problem-solving skills

Strong negotiation skills

Exceptional communication (written and verbal), collaboration, influencing, listening, and interpersonal skills to effectively develop productive working relationships both within and outside Arch

Able to process large amounts of complex information, distill it down to key issues and decision points and concisely communicate the information verbally and in writing

Able to effectively lead strategic discussions and leverage technical knowledge to make sound, cost-effective decisions and recommendations

Able to work well independently and in a highly collaborative team environment

Adaptable and able to succeed in a rapidly changing workplace

Strong Microsoft Excel, PowerPoint and Word skills

Willing and able to travel approximately up to 10% of time

Maintains all required state adjustor licenses