Complex Claims Specialist – MPL

Complex Claims Specialist – MPL

• Job ID: 12053
• Department: Claims
• Employment type: Permanent - Full time

• Location(s): Atlanta | Chicago | Phoenix
• Preferred education: Bac + 4 or Equivalent

Job description:

The Role:

The Complex Claims Specialist is a high-level adjuster role that adjudicates assigned claims within given authority  and provides operational support to the claims team. This person also:

• Adjusts and resolves complex to severe claims that includes all phases of litigation
• With minimal supervision, drafts complex coverage letters, including reservation of rights and denial letters
• Reviews and analyses claim documentation and legal filings
• Drives litigation best practices to lead defense strategy on litigated files
• Mentors Claim Examiners and Associate Claim Examiners
• Uses superior knowledge and experience to affect positive claim outcome via investigation, negotiation and utilization of alternative dispute resolutions
• Identifies emerging exposures and claims trends
• Identifies suspected fraudulent claims and tracks with special investigations unit
• Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities
• Develops content and conducts training for claims team and underwriters as requested

The Team:       

The US Claims team at Hiscox is a growing group of professionals working together to provide superior customer service and claims handling expertise. The claims staff are empowered to manage their claims within given authority to provide fair and fast resolution of claims for our insured and broker partners. With strong growth across the US business, the Claims team is focused on delivering profitability while reinforcing Hiscox’s strong brand built on a long history of outstanding claims handling.

What we offer:

• Competitive salary and bonus (based on personal & company performance) 
• 401(k) with competitive company matching 
• Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care)  
• Company paid group term life, short- term disability and long-term disability coverage 
• 24 Paid time off days, 10 paid holidays, and ability to purchase 5 PTO days 
• Paid parental leave 
• 4 week paid sabbatical after every 5 years of service 
• Financial Adoption Assistance and Medical Travel Reimbursement Programs 
• Annual reimbursement up to $600 for health club membership or fees associated with any fitness program 
• Company paid subscription to Headspace to support employees’ mental health and wellbeing 
• Recipient of 2021 Cigna’s Well-Being Award for having a best-in-class health and wellness program 
• Dynamic, creative and values-driven culture 
• Modern and open office spaces, complimentary drinks 
• Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation 

Person specification:

Requirements:

1. 8+ years of claims handling experience. A JD from an ABA accredited law school may be considered as a supplement to claims handling experience
2. Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation
3. Advanced knowledge of coverage within the team’s specialty or focus
4. Advanced knowledge of litigation process and negotiation skills
5. Experience in mentoring and training other claims examiners
6. Excellent verbal and written communication skills
7. Advanced analytical skills
8. B.A./B.S degree from an accredited College or University preferred

Additional Factors Considered:

1.     Ability to act a subject matter expert within team
2.      Demonstrated ability to work with minimal oversight
3.     Experience attending and leading mediations, arbitrations and trials
4.      Demonstrated ability to advance product innovation or develop a greater understanding of other aspects of the business through training or other relevant projects
5.      Demonstrates courage in addressing and solving difficult or complex matters with insureds, attorneys and brokers
6.      Demonstrated steps taken toward additional certifications by an approved authority such as a CPCU, ARMS or AINS designation
7.      Commitment to professional development and learning demonstrated by at least 5 hours of continuing education related to insurance topics through Success Factory, Hiscox in-person or video conference training sessions, or other in-person seminars or webinars.

Salary range $90,000.00 - $150,000.00

Compensation Overview

The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.