Address
Form of workJob Title
Complex Claim Analyst
Location
Hybrid (Manchester, NH or Rockville Centre, NY) or Remote
Summary
This position is with Rockville Risk Management Associates, a third-party administration arm of The RiverStone Group. Reporting to the Head of Management & Professional Liability, this role is primarily responsible for direct handling of Intellectual Property (Media), Technology Errors & Omissions (E & O) and Cyber Liability claim types. The candidate will manage a portfolio of primary and excess claims that include higher exposure, greater severity and/or complexity. Duties include resolution of coverage and liability issues, claim evaluation, establishment of adequate reserves, litigation management, case resolution and transaction processing, and implementation of strategic initiatives relating to liability work matters, in alignment with the Company's Strategic Vision.
Essential Functions
- 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 coverages; establishes adequate reserves; and investigates and handles claims involving umbrella and excess policies.
- Manages litigation with agreed upon counsel under carrier approved fee arrangements pursuant to counsel/litigation guidelines.
- Pursues and maximizes all risk transfer opportunities by contract or by insurance policy language.
- Assigns and manages work of defense counsel, approval and monitoring of expert witnesses and interfacing with peer carriers including analysis of indemnity contracts and cost sharing, evaluation of liability and damages, participation in settlement negations and mediations, drafting and/or reviewing settlement agreements and releases.
- Ensures proper file setup, reserving, general handling and application of company procedure.
- Participates in developing claims handling strategy, 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, reports to the proper MGA, Carrier, and/or Syndicate
- Handles large volume of diverse and dynamic claims effectively.
- Empowered to make decisions within job description and authority. Seeks guidance where appropriate.
- Develops 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 Rockville Risk Management Associates/RiverStone's business processes/systems and develops and escalates ideas and solutions.
- Seeks continuous development by identifying areas for growth and improvement. Works with continuous improvement 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.
- Performs 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.
- Travels as required.
- Obtains and maintains claims adjuster licenses in those states requiring them.
- Mastery of the Claims Analyst functions.
- Anticipates and identifies risks and opportunities on coverage and liability.
- Mentors and guides less experienced claim analysts.
- Assists the Liability Claim Manager with departmental problem solving.
- Serves on Companywide committees and projects as assigned.
Related Functions
- Demonstrates ability and flexibility in a dynamic environment.
- Excellent analytical, interpersonal and communications skills, both written and oral.
- Customer service oriented with the ability of developing long lasting relationships with internal and external business partners.
- Effective organizational skills are required. Must be able to prioritize and handle multiple assignments or projects simultaneously and meet established deadlines.
- Critical thinking and problem-solving skills.
- Business acumen.
- Ability to negotiate contracts and implement cost containment strategies.
- Must be able to delegate tasks and follow up through delivery.
- Excellent interpersonal skills with an ability to interact with people at all levels of the organization.
- Strong verbal and written communication skills
Required Skills
- Substantial knowledge of issues in Intellectual Property, Tech Errors and Omissions and Cyber liability claims.
- Excellent negotiation and communication skills. Some technical writing experience. Proficient with Microsoft Office products, internet research and typing.
- Excellent interpersonal and organization skills.
- Ability to accurately and timely analyze coverage and instruct and collaborate with counsel regarding litigation strategy and claim resolution and resolve claims and otherwise act within the scope of delegated authority.
Organizational
- Demonstrates alignment with Rockville Risk Management Associates/RiverStone's Commitments.
- Prioritizes and organizes work in self-directed manner.
- Attains and maintains knowledge of assigned department.
- Performs other duties as required, including supporting and coordinating with other department colleagues.
- We empower people to make decisions, in a supportive environment, with accountability for the outcomes.
Experience
3-7 years' experience in Management/Professional Liability claims or related civil litigation role.
Required Education
Four-year college degree is required
Preferred Education or Certification
JD, CPCU, RPLU, SCLA, CCLA
Supervisory Role
No
Travel
Some traveled required - up to 10-15% of the time.
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. RiverStone retains the right to change or assign other duties to this position as needed.
Core Competencies
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.
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.
Process Management: Good at figuring out the processes necessary to get things done; knows how to organize people and activities; understands how to separate and combine tasks into efficient flow; knows what to measure and how to measure it; can see opportunities for synergy and integration where others can't; can simplify complex processes; gets more out of fewer resources.
Sizing Up People: Is a good judge of talent; after reasonable exposure, can articulate the strengths and limitations of people inside or outside the organization; can accurately project what people are likely to do across a variety of situations.
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.
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.
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