Sr. Claims Examiner - Commercial Liability

Position Summary:

This position will entail the handling of multi-jurisdiction personal homeowners' liability claims as well as commercial general liability, condominium and construction defect claims.

Duties and Responsibilities:Makes timely initial contact and appropriate follow up contact with all relevant parties to provide explanation of claim process, set expectations, gather facts and provide information on developments.Performs and documents initial coverage analysis and recognizes potential coverage issuesConducts, directs and/or oversees the development of facts necessary to address coverage, liability and damage aspects of the claimEvaluates facts to properly analyze applicable coverage issuesDrafts coverage letters including declinations, reservation of rights, excess and partial denialsApplies relevant jurisdictional laws and uses independent judgement to reach liability determinations based upon the factsGathers appropriate supporting damage documentation and evaluates amounts owed for property damage/bodily injury/personal injury based upon analysis of coverage, liability, damage and relevant jurisdictional lawsEffectively communicates claim decisions verbally and in writing to policyholders, claimants, attorneys and agentsProperly updates claim file with key activities and documentsMaintains effective diary system to bring claims to timely resolutionCommunicates effectively with internal business partners including Customer Service and UnderwritingDevelops constructive relationships and works effectively with outside vendors such as independent adjusters, coverage counsel and defense counselEstablish appropriate reserves based upon competent analysis of coverage, liability and damages and adjust reserves as necessary in a timely manner upon receipt of additional relevant information.Apply common sense and cost-benefit analysis to claim decisionsComplete necessary claim reporting to management including high exposure alert notificationsDevelops and executes plan of action to resolve claims within scope of authorityConducts Medicaid/Medicare reporting in accordance with federal lawReviews invoices for accuracy and completes timely expense and indemnity disbursements assuring compliance with tax reporting requirementsOversees handling of cases in litigation and provides appropriate guidance to defense counselAttends and actively participates in mediations and other forms of alternate dispute resolution where required by the court or where appropriate to move the claim to a timely and proper resolutionRecognizes potential third-party tortfeasors and develops facts to support the likeliness of successful recoveryPrepares appropriate claim updates for management and excess carriersParticipates in claims reviews and roundtable discussions and presents issues and recommendations in a precise and understandable manner

SKILLS AND ABILITIES:Exceptional customer service skillsEmotional intelligence and ability to manage conflictAdvanced analytical, problem-solving and decision-making skillsAbility to communicate effectively verbally and in writing with varying audiencesExcellent negotiation skills and track record of proven resultsTeam-player who is comfortable working in a dynamic, entrepreneurial environmentWillingness to simultaneously work on multiple projects and fulfill multiple rolesProven leadership and mentoring capabilitiesAbility to interpret a variety of policy forms and endorsementsHistory of litigation claims management and working effectively with defense counselFamiliarity with reading and interpreting contracts, statutes and case lawStrong computer skills and advanced knowledge of Microsoft products

QUALIFICATIONS:Bachelor's degree or higher5 years liability claim handling experience (multi-jurisdiction and some condominium and commercial liability claim handling preferred) 5 years bodily injury evaluation and negotiation experience (serious injury preferred)Licensed to adjust claims in Florida (multi-state licensing preferred)

General Information:

All employees must pass a pre-employment background check. Other checks may be needed based on position: driving history, credit report, etc.

Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time.

Heritage Insurance Holdings, Inc. is an Equal Opportunity, Affirmative Action Employer. We will not discriminate unlawfully against qualified applicants or employees with respect to any term or condition of employment based on race, color, national origin, ancestry, sex, sexual orientation, age, religion, physical or mental disability, marital status, place of birth, military service status, or other basis protected by law.