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AF - Group · 23 hours ago

Senior Claim Representative - Legal

United States

Full-time

Remote

Mid, Senior Level

$83K/yr - $139K/yr

5+ years exp

AF - Group is seeking a Senior Claims Representative to manage and resolve complex commercial casualty claims. The role involves extensive negotiation, evaluation of coverage, and collaboration with legal counsel, requiring independent decision-making and strong communication skills.

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Comp. & Benefits

Responsibilities

Promptly and efficiently adjust a caseload of the company’s most complex and volatile casualty claim files in accordance with company policies and procedures. This caseload will represent suits and third-party liability claims where successful collaboration with outside counsel is required

Maintain an active diary and updated plan of action on 100% caseload files

Adhere to assigned authority limits for reserving and payments (including settlements)

Exercise independent decision-making skills with minimal to moderate supervision and direction on claims assigned, using knowledge of local codes, standards, and law

Evaluate coverage thoroughly for each claim received and work closely with internal counsel to ensure each coverage position taken is correct

Investigate the facts of each claim, including obtaining key documentation such as police reports, medical reports, appraisals, estimates, photographs, etc. to evaluate claims in accordance with company standards. This may include traveling to observe key locations or discuss the case with insureds, attorneys, or key witnesses and experts

Evaluate each claim’s value, recommend appropriate reserves, and ensure that reserves are maintained at appropriate levels as the claim develops

Evaluate and make decisions regarding coverage, liability, and compensability

Timely present cases to management and other relevant associates for the purpose of discussing strategy, setting reserves, and obtaining payment authority

Negotiate settlements or deny payments where no coverage, liability, or compensability exists

Attend mediations, settlement conferences, arbitrations, and trials when appropriate

Identify and thoroughly investigate all recovery and subrogation opportunities for each claim

Return all telephone calls within one (1) business day, when possible. All messages from customers and agents are to be returned by the end of the same business day on which the call was received. Report all service complaints to management immediately upon receipt

Maintain personal compliance with all continuing education requirements as mandated by statute or by office policy

Providing occasional training and mentoring for other members of the team as well as the claims department

Adhere to the company’s code of ethics

Perform related duties assigned

Qualification

Complex claims managementLegal knowledgeNegotiation skillsJuris Doctor degreeState adjusting licenseCustomer service skillsCommunication skillsProblem-solving abilityOrganizational skillsPresentation skills

Required

Bachelor's degree from a 4-year college or university

At least 5 years of experience managing large and/or complex commercial casualty claims and demonstrated knowledge and ability to do so at a high level of performance

Excellent oral and written communication skills

Excellent presentation and facilitation skills

Ability to make competent, independent decisions

Ability to analyze coverage submissions and help

Ability to prioritize, organize and plan work for self and others

Excellent customer service skills

Superior problem-solving ability

Thorough knowledge of claim procedures, policies, terminology, etc

Computer proficient with Microsoft Office programs, such as Word, Excel, and Outlook

Possess State adjusting license(s) as applicable

Ability to travel as required

Ability to interact professionally with others

Sit, stand/walk ambulatory

Ability to lift ten pounds

Preferred

Juris Doctor degree (weighed favorably, but not a requirement)

Admission to the state bar preferred

Company

AF - Group

AF Group is a nationally recognized holding company whose affiliated insurance companies are premier providers of specialty insurance solutions offered through independent agents nationwide.

Founded in 1912

Lansing, Michigan, USA

1001-5000 employees