Senior Liability Claims Specialist

The Senior Liability Claims Specialist is responsible for the investigation, evaluation, negotiation, and resolution of complex insurance claims while ensuring compliance with company policies, regulatory requirements, and industry best practices. This position serves as a technical leader within the Claims Department by providing guidance to less experienced claims professionals, assisting with training and quality initiatives, and supporting continuous process improvement. The Senior Liability Claims Specialist exercises sound judgment, demonstrates advanced knowledge of insurance coverage and claims handling practices, and is committed to delivering exceptional service to policyholders while protecting the financial interests of the Company.

Essential Duties and Responsibilities

Claims Administration

• Investigate, evaluate, negotiate, and resolve complex and high-exposure insurance claims.


• Analyze policy coverage, determine liability, establish reserves, and authorize payments within delegated authority.


• Monitor investigations through interviews, document review, inspections, and consultation with experts.


• Identify potential fraud indicators and coordinate with SIU or legal counsel.


• Ensure timely and equitable claim resolution.

Technical Leadership

• Serve as a subject matter expert.


• Mentor and coach Claims Specialists and junior staff.


• Assist with quality assurance audits and training.

Customer and Stakeholder Relations

• Maintain professional relationships with policyholders, claimants, attorneys, adjusters, contractors, vendors, and regulators.


• Communicate coverage decisions and negotiate settlements.

Compliance and Documentation

• Maintain accurate claim files.


• Ensure compliance with regulations and company policies.


• Prepare documentation for litigation or regulatory review.

Operational Excellence

• Participate in process improvement initiatives.


• Assist with catastrophe response and special projects.

Required Qualifications

Education

Bachelor's degree in Business Administration, Risk Management, Insurance, Finance, Criminal Justice, or related field preferred. Equivalent experience may be considered.

Experience

Minimum seven (7) years of progressively responsible property and casualty claims handling experience. Experience with complex or litigated claims and mentoring staff required.

Licenses and Professional Designations

Active adjuster's license where required. Preferred: AIC, CPCU, SCLA, or AINS. JD applicants welcome to apply.

Knowledge, Skills, and Abilities

Comprehensive knowledge of insurance coverage and claims practices; strong analytical, investigative, negotiation, communication, organizational, and leadership skills; proficiency with claims management systems and Microsoft Office; ability to work independently and collaboratively.

Leadership Competencies

Demonstrate technical expertise, foster collaboration, promote continuous improvement, exercise sound judgment, and model professionalism and ethical decision-making.

Performance Expectations

Maintain high-quality claim files, meet productivity standards, ensure compliance, resolve complex claims efficiently, support customer satisfaction, mentor staff, and contribute to departmental success.

Physical Requirements

Office or hybrid work environment; prolonged computer use; occasional travel for inspections, mediations, trials, and training.

Disclaimer

This job description describes the general nature of the position and is not intended to be an exhaustive list of duties. Management reserves the right to modify responsibilities as business needs require.