Senior Technical Claim Specialist

Senior Technical Claim Specialist

Join and apply for the Senior Technical Claim Specialist role at Church Mutual Insurance Company, S.I.

As a Senior Technical Claim Specialist, you will handle large, complex claim files, including litigated matters, catastrophic claims, umbrella claims, punitive damage claims, severe injury, long duration indemnity, permanent total disability, structural building damage, and multiple-location damage with business income exposure. You will set reserves, settle claims within your authority, direct work with defense attorneys, actively share knowledge with team members, contribute to training programs, and mentor other claim representatives.

• Perform claim tasks timely and document claim files appropriately.
• Make informed coverage decisions and deny losses within authority level, providing detailed explanations and citing policy language.
• Conduct thorough investigations based on claim complexity and severity, including site inspections and analysis of potential liability and compensability denials.
• Determine and set reserves based on probable claim outcomes, negotiate directly with insured, claimant, or claimant's attorney, and review claim facts with claims management.
• Maintain a professional, courteous, and helpful approach when communicating with internal and external customers, partners, and brokers.
• Provide knowledge and guidance to other claim handlers regarding claim strategy, coverage interpretations, and legal nuances.
• Investigate and refer identified claims to loss recovery services as applicable.
• Direct work of defense attorneys through collaboration on claim strategy and resolution.
• Engage in direct investigation, control, and settlement negotiations when outside adjusting and legal services are not necessary or available.
• Attend mediations, depositions, and trials, and present complex claim files during round tables and claims committee meetings.
• Stay abreast of current and emerging complex litigation/claim settlement issues, trends, court decisions, and plaintiff bar activities.
• Actively communicate and share knowledge of trends, litigation environment, and potential impacts with key CM Group stakeholders.

• Bachelor's degree preferred; equivalent education and/or experience may be considered in lieu of a degree.
• Evidence of continuing education in the insurance industry is required.
• Additional legal education or law degree is highly desirable.
• AIC and/or CPCU designation is highly preferred.
• Typically, fifteen or more years in technical insurance claim roles with increasing responsibilities is required.
• Ability to obtain and maintain state adjusting license requirements and complete continuing education requirements.
• Advanced knowledge of recoveries such as subrogation, reinsurance, apportionment, and deductibles.
• Advanced knowledge of reinsurance contracts, workers' compensation pools, second injury funds, etc.
• Advanced negotiation skills.
• Strong listening, verbal, and written communication skills.
• Advanced knowledge of policy terminology, legal principles involving insurance, and emerging industry trends.
• Effective planning and organization skills.
• Ability to travel to inspect loss sites, attend mediations, depositions, etc.

Church Mutual is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

Exact compensation will vary based on consideration of a variety of factors including education, skills, experience, and location – Remote.