Liability Specialist (Hybrid/Remote)

The Liability Claims Specialist is responsible for managing a caseload of simple to complex cases within PRISM's Liability program. Caseload management requires monitoring and evaluating member claim files, reserves and coverage; collaborating with third party administrators (TPAs) and self-administered members with regard to settlement or defense of their claim files; updating PRISM's file records; presenting claims to the Claims Review Committees; and creating and maintaining open and constructive channels of verbal and written communication with all members, TPAs, defense counsel, and reinsurers/excess carriers.

Job Responsibilities:

• Maintain diary to document updates, correspondence, and strategies towards resolution on a 150 - 200 pending claims caseload.
• Monitor and evaluate case strategy, litigation management, reserves and case statuses to ensure compliance with applicable PRISM Standards.
• Work with members and/or TPAs to ensure they are compliant with PRISM Standards in all aspects of claims handling.
• Make decisions regarding coverage for lesser complex exposures and generate coverage related correspondence.
• Properly code claim files in accordance with the PRISM GL coding.
• Engage coverage counsel on complex exposures as needed.
• Update reinsurers/excess carriers on cases involving their layer and/or cases they are monitoring.
• Present claims to the appropriate committees for settlement authority or coverage determination.
• Update information concerning claims and maintain claims files within the claims system, including documentation of analysis of the exposure and plan of action, file material in electronic environment, and appropriate claims fields in the system to maintain data integrity.
• Generate requisite reports from claims files.
• Contact member agencies, TPAs, defense counsel or reinsurers/excess carriers concerning claims status and information.
• Create and maintain positive, collaborative relationships with members, committees, and staff.
• Actively participate in committee meetings as necessary.
• Attend mediations/MSCs as needed.
• There will be a moderate amount of travel.
• Support PRISM Core Values and PRISM Mission.
• Assist with the overall success of the organizational strategic plan, goals, and objectives of the organization.
• Maintain a strong customer service focus both internally and externally.
• Foster member relationships and assist members when needed.
• Perform other duties as assigned.