Technical Claims Specialist

Technical Claims Specialist
Houston, TX
A well-respected Insurance Carrier is seeking a qualified and experienced Technical Claims Specialist to join our dynamic team.
As a Technical Claims Specialist, you will play a crucial role in managing and resolving a variety of commercial claims, including general liability, property, Inland Marine, automobile bodily injury, property damage, and potentially worker's compensation claims.
If you have a strong background in claims handling, exceptional communication skills, and a commitment to delivering excellent service, we invite you to apply for this exciting opportunity.
Key Responsibilities:

• Handle, negotiate, and resolve first and third-party commercial claims, ensuring compliance with company policies and state regulations.
• Conduct thorough investigations, maintaining constant communication with customers and relevant internal and external stakeholders.
• Document all key activities, contacts, and statements, including comprehensive outlines of claim requirements.
• Demonstrate proficiency in medical terminology, treatment, and injury descriptions.
• Recognize and assess potential damage related to injuries.
• Manage the claim authorization process and complete loss investigations using appropriate techniques.
• Evaluate compensability and exposure, identifying subrogation opportunities and suspicious claims.
• Prepare accurate and timely reports and state filings as required.
• Establish and maintain accurate reserves, adhering to state regulatory compliance requirements.
• Verify, analyze, and apply coverage correctly.
• Develop negotiation strategies for claims resolution, considering state compliance and company policies.
• Create resolution plans based on a thorough analysis of facts, defenses, compensability, and statutory/case law.
• Keep policyholders, underwriting, and agents informed of file status and other relevant matters.
• Participate in presentations, meetings, or visits related to claims resolution, service, or technical issues.
• Stay updated with relevant continuing education requirements.

Candidate Qualifications Sought:

• Minimum of 7 years of multi-line claims experience.
• Current Texas claims adjuster license required; additional licenses are a plus.
• Preferred experience in handling claims across multiple jurisdictions.
• Familiarity with Contractual Risk Transfer concepts and anti-indemnity laws.
• Strong attention to detail and accuracy in documentation and data management.
• Excellent written and verbal communication skills, with a strong ability to listen effectively.
• Adept at resolving differences in opinions and misunderstandings through open discussion.
• Demonstrates accountability for actions and holds self and others responsible to organizational standards.
• Exceptional organizational skills and the ability to prioritize work effectively.

Join our client’s team and make a significant impact in the field of claims management. If you meet the qualifications and are ready to take on this challenging and rewarding role, we encourage you to apply today.