Coverys
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Claim Consultant - Midwest
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Coverys . The Claim Consultant provides complete claim loss services for policyholders. This role investigates, evaluates, and disposes of MPL and General Liability claims with varying degrees of complexity and severity. The Claim Consultant works independently to provide claim-loss service for Coverys policyholders, investigating and adjusting claims with high levels of complexity and severity. Essential Duties & Responsibilities
Interview insureds, claimants, witnesses, and other appropriate parties to obtain information used to assess liability exposure. Document related files regarding results of investigation and negotiations. Prepare reports to file on established diary dates and other specific reports as needed to ensure timely file documentation and plan of action. Secure records for investigation and evaluation of cases. Determine and implement negotiation strategy and negotiate settlements within authority level. Adjust reserves timely within level of authority and make reserve recommendations to Manager/Director for amounts over position authority level. Advise Claim Director and/or S.V.P. of Claims on claims status and attend Reserve & Settlement Committee Meetings as necessary. Ensure timely reporting to the Reserve and Settlement Committee. Interact with other departments to facilitate and coordinate services to insureds and clients. Evaluate cases for appropriate disposition and seek authority for settlement from Manager/Director when settlement requests exceed authority. Direct and monitor activities of defense counsel in compliance with Case Management Guidelines. Monitor trials and attend pre-trial proceedings, mediations, and arbitrations as necessary. Identify significant insured Risk Management or Underwriting issues and relay information to the appropriate department. Communicate with insureds, claimants, and witnesses; review medical and relevant records; conduct investigations according to claim type. Analyze and verify insurance coverage for claims against policyholders. Maintain working knowledge of policy forms and confirm policy in effect for the date of loss. Education, Requirements & Competencies
Bachelor's degree from a four-year college or university. R.N. or J.D. preferred with 3-5 years’ experience in clinical nursing and/or claims experience dealing with serious bodily injury. Knowledge of medical, legal, and insurance terminology required. Must hold a current driver's license. Strong written and oral communication skills. Training in contract/policy review and application required. Comfortable making oral presentations to staff and insureds. Ability to synthesize complex or diverse information, research data, and design workflows and procedures. Ability to develop and implement creative solutions. Insurance adjuster's license may be required in specific states. Ability to travel 20-25% required. The base salary range is $87,600 - $118,500. Compensation depends on factors like location, skills, experience, and education. If you're caring and customer-focused, Coverys is the right company for you! Additional Information
Seniority level: Mid-Senior level Employment type: Full-time Job function: Finance and Sales Industry: Insurance
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Claim Consultant - Midwest
role at
Coverys . The Claim Consultant provides complete claim loss services for policyholders. This role investigates, evaluates, and disposes of MPL and General Liability claims with varying degrees of complexity and severity. The Claim Consultant works independently to provide claim-loss service for Coverys policyholders, investigating and adjusting claims with high levels of complexity and severity. Essential Duties & Responsibilities
Interview insureds, claimants, witnesses, and other appropriate parties to obtain information used to assess liability exposure. Document related files regarding results of investigation and negotiations. Prepare reports to file on established diary dates and other specific reports as needed to ensure timely file documentation and plan of action. Secure records for investigation and evaluation of cases. Determine and implement negotiation strategy and negotiate settlements within authority level. Adjust reserves timely within level of authority and make reserve recommendations to Manager/Director for amounts over position authority level. Advise Claim Director and/or S.V.P. of Claims on claims status and attend Reserve & Settlement Committee Meetings as necessary. Ensure timely reporting to the Reserve and Settlement Committee. Interact with other departments to facilitate and coordinate services to insureds and clients. Evaluate cases for appropriate disposition and seek authority for settlement from Manager/Director when settlement requests exceed authority. Direct and monitor activities of defense counsel in compliance with Case Management Guidelines. Monitor trials and attend pre-trial proceedings, mediations, and arbitrations as necessary. Identify significant insured Risk Management or Underwriting issues and relay information to the appropriate department. Communicate with insureds, claimants, and witnesses; review medical and relevant records; conduct investigations according to claim type. Analyze and verify insurance coverage for claims against policyholders. Maintain working knowledge of policy forms and confirm policy in effect for the date of loss. Education, Requirements & Competencies
Bachelor's degree from a four-year college or university. R.N. or J.D. preferred with 3-5 years’ experience in clinical nursing and/or claims experience dealing with serious bodily injury. Knowledge of medical, legal, and insurance terminology required. Must hold a current driver's license. Strong written and oral communication skills. Training in contract/policy review and application required. Comfortable making oral presentations to staff and insureds. Ability to synthesize complex or diverse information, research data, and design workflows and procedures. Ability to develop and implement creative solutions. Insurance adjuster's license may be required in specific states. Ability to travel 20-25% required. The base salary range is $87,600 - $118,500. Compensation depends on factors like location, skills, experience, and education. If you're caring and customer-focused, Coverys is the right company for you! Additional Information
Seniority level: Mid-Senior level Employment type: Full-time Job function: Finance and Sales Industry: Insurance
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