Complex (or Senior) Claims Analyst, GL

Complex (or Senior) Claim Analyst

Reporting to the Unit Manager, this role will be responsible for direct handling of multi-line commercial claims including Auto, General Liability and Construction Defect claims. Duties include investigation and evaluation of coverage, liability and damages issues. The role will be responsible for claim evaluation, establishment / recommendation of adequate reserves, litigation management, case resolution and transaction processing in alignment with the Company's and Client's Strategic Vision.

Essential Functions

• In addition to the essential functions of a Complex Claim Analyst, the Senior Claim Analyst handles more complex cases and / or industry specific cases that include higher exposure with an increase in severity and complexity.
• Mastery of the Complex Claim Analyst functions and Company's and Client's systems.
• Anticipates and identifies risks and opportunities on coverage and liability.
• Mentors and guides less experienced claim analysts.
• Assists the Unit Manager with departmental problem solving.
• Manages external relationships including third party administrative oversight.
• Serves on Companywide committees and projects assigned.
• Directly handles and / or assists in monitoring, reviewing, and coordinating the activities involving commercial and personal lines insurance claims, including analysis of coverage issues, establishment of adequate reserves, and the resolution and closure of claims.
• Reviews loss notices; confirms and interprets policy coverage; establishes adequate reserves; and investigates and handles claims involving primary, umbrella and excess policies.
• Manages litigation with Preferred Counsel under Alternative Fee Arrangements or other defense fee structures.
• Pursues and maximizes all risk transfer opportunities by contract or by insurance policy language.
• Assigns and manages work of defense counsel, assignment of expert witnesses and interfacing with peer carriers including design and execution of defense and indemnity contracts, evaluation of liability and damages and participation in settlement negations.
• Ensures proper file setup, reserving, general handling and application of company procedure.
• Participates in developing claims handling strategies, including defense coordination, litigation strategy and budgets, and expense control.
• Records specific claims information and reports as appropriate to a manager relative to pertinent financial and general statistical records.
• Maintains diary control, investigates, analyzes, and reports to ensure maintenance of proper reserves to reflect the company's exposure and reports to our Reinsurance Department to assist in providing notice to reinsurers and the Reinsurance Department's recovery of specific amounts when payment exceeds the company's retention.
• Handles large volume of diverse and dynamic claims effectively.
• Empowered to make decisions within job description and authority. Seeking guidance where appropriate.
• Develop creative ideas and solutions to real-time business problems and / or business opportunities; Takes reasonable, calculated risks even if failure is possible.
• Empowers self and teammates to continuously improve Company's business processes / systems and develops and escalates ideas and solutions.
• Seeks continuous development by identifying areas for growth and improvement. Works with team to implement process and technical improvements.
• Consistently delivers superior customer service to both internal and external business partners.
• Understands Key Performance Indicators and manages towards those priorities.
• Perform special projects and assignments related to area of authority as necessary.
• Maintains confidentiality.
• Establishes and maintains professional relationships.
• Assists in Due Diligence inquiries as assigned.
• Obtains and maintains claims adjuster licenses in those states requiring them.

Organizational

Related Functions

Required Skills

Experience

Minimum of 5 years of claims handling experience or a related field.

Required Education

Four-year college degree required or equivalent work experience.

Preferred Education or Certification

JD, CPCU, SCLA, CCLA

Supervisory Role

Schedule, assign, and review the work of others in compliance with specific instructions.

Travel

As required, based upon business needs.

Work Environment / Physical Demands

This position operates in a professional based collaborative environment and must have the ability to timely produce thorough, accurate work with many competing demands, deadlines, and distractions. The position uses standard equipment such as phones, computers, copiers / printers and filing cabinets. Noise level is moderate.

Core Competencies

Customer Focus : Builds strong customer relationships and delivers customer-centric solutions; gains insight into customer needs, identifies opportunities that benefit the customer; builds and delivers solutions that meet customer expectations and establishes and maintains effective customer relationships.

Timely Decision Making : Makes decisions in a timely manner, sometimes with incomplete information and under tight deadlines and pressure; able to make a quick decision.

Ethics and Values : Adheres to an appropriate (for the setting) and effective set of core values and beliefs during both good and bad times; acts in line with those values; rewards the right values and disapproves of others; practices what he / she preaches.

Learning on the Fly : Learns quickly when facing new problems; a relentless and versatile learner; open to change; analyzes both successes and failures for clues to improvement; experiments and will try anything to find solutions; enjoys the challenge of unfamiliar tasks; quickly grasps the essence and the underlying structure of anything.

Negotiating : Can negotiate skillfully in tough situations with both internal and external groups; can settle differences with minimum noise; can win concessions without damaging relationships; can be both direct and forceful as well as diplomatic; gains trust quickly of other parties to the negotiations; has a good sense of timing.

Priority Setting : Quickly zeros in on the critical few and puts the trivial many aside; can quickly sense what will help or hinder accomplishing a goal; estimates roadblocks; creates focus; spends his / her time and the time of others on what's important.

Problem Solving : Uses rigorous logic and methods to solve difficult problems with effective solutions; probes all fruitful sources for answers; can see hidden problems; is excellent at honest analysis; looks beyond the obvious and doesn't stop at the first answers.

Time Management : Uses his / her time effectively and efficiently; values time; concentrates his / her efforts on the more important priorities; gets more done in less time than others; can attend to a broader range of activities.

Written Communications : Is able to write clearly and succinctly in a variety of communication settings and styles; can get messages across that have the desired effect.

Diversity, Equity, Inclusion & Belonging

RiverStone Resources, LLC is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, LGBTQ+, national origin, gender identity, disability, protected veteran status, or any other characteristic protected by law.