Specialty Casualty Claims Specialist
About the role
**Position is eligible to work from home anywhere in the US**
Essential Functions
- Manage highly complex litigated casualty claims from investigation through resolution.
- Analyze coverage, liability, damages, contracts, statutes, and policy language to determine claim exposure.
- Develop litigation strategies with defense counsel, including lawsuit analysis, action plans, and settlement recommendations.
- Negotiate settlements with claimants, plaintiff attorneys, insureds, and other stakeholders.
- Attend and oversee trials, depositions, mediations, arbitrations, and other litigation proceedings.
- Set, monitor, and adjust reserves while preparing large loss reports and presenting complex cases in claims roundtables.
- Draft reservation of rights, coverage position, and denial letters while ensuring regulatory compliance.
- Direct investigations by gathering statements, reviewing reports, preserving evidence, and coordinating with attorneys, experts, and vendors.
- Identify recovery opportunities, manage liens (including Medicare), and pursue subrogation and other cost-recovery efforts.
- Review legal budgets, invoices, estimates, and vendor expenses to ensure accuracy and cost-effective claim resolution.
- Serve as a technical expert and mentor, providing guidance on complex coverage, liability, investigation, and claims handling issues.
- Partner with Underwriting, Risk Improvement, Legal, SIU, Medical Review, and other internal teams to evaluate risk exposures and deliver exceptional claim outcomes.
Education & Experience
- Bachelor's degree or equivalent relevant experience
- Eight years of casualty claims adjusting experience or related experience, including at least four years of experience within assigned specialty line of business
- Experience with Public Entity, EPLI, E&O, and/or Law Enforcement claims highly preferred
- Relevant insurance designations preferred
Knowledge, Skills & Abilities
- Excellent knowledge of best claims practices used to resolve the most serious and complex liability claims
- Advanced knowledge of insurance contracts, medical terminology and substantive and procedural laws
- Excellent knowledge of computers and claims systems.
- Ability to obtain all applicable state licenses
- Ability to adhere to high standards of professional conduct and code of ethics
- Exceptional organizational and empathetic interpersonal skills.
- Thorough written and verbal communication skills
- Advanced customer service skills
- Ability to maintain confidentiality
- Thorough investigative and problem-solving abilities.
- Occasional travel required; a valid driver's license with an acceptable motor vehicle report per company standards required if driving
The hiring salary range for this position will vary based on geographic location, falling within either of the following: $92,670 - $128,045 or $102,443 - $140,845 A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs. For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit
www.emcins.com/careers
All of our locations are tobacco free including in company vehicles.
Not included in the source posting: benefits.
Who can apply
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