Complex Claims Specialist

Company Farm Family Farm Family specializes in farm and ranch protection with a wide range of products including flexible farm packages, business owner policies, commercial package, workers compensation, commercial auto and select personal auto coverage. Farm Family is a leader in serving the Northeast and Mid-Atlantic markets and is pursuing growth across the U.S. The Farm Family entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc.

We are looking for a highly capable Complex Claim Specialist to join our team and work from our Omaha office. Alternatively, we can fill this position in our Albany office. We work together in the office five days a week in order to strengthen our culture, build team connections, and drive profitability. The position is responsible for the investigation, evaluation, negotiation, and settlement of complex and high exposure general liability claims, including some commercial auto claims.

This includes assessing coverage; contacting the insureds, claimants, and witnesses; engaging experts when needed to fully investigate the facts of the loss and to arrive at a proper conclusion in assessing liability and damages. The Complex Claim Specialist is ultimately responsible for liability and coverage decisions, damage assessments and the negotiation of a claim to conclusion. Handling UM/UIM exposures and reviewing litigation strategy and actions of defense counsel for claims involving Arbitration.

Provide the insured with the promise of the policy and excellent customer service. This is a 100% in-office position. Candidates must be able to work on-site at a designated company office during standard business hours.

• Working under limited technical direction and within broad limits and authority, adjudicate complex and high exposure third-party general liability bodily injury and property damage claims, potentially with significant impact on departmental results.
• Providing laser-focused customer service to our clients by providing superior claims outcomes and developing meaningful and long-lasting connections with our insured and brokers.
• Analyzing claims forms, policies and endorsements, client instructions, and other records to determine whether the loss falls within the policy coverage.
• Address any excess policies that may be applicable to the loss.
• Completion of the claim investigation, and/or review of the initial investigation on reassigned files promptly and thoroughly to properly assess and evaluate the liability exposure and to ensure proper reserving for a given exposure in accordance with the company’s reserving philosophy.
• Secure recorded statements from all parties; document file activity in a concise and comprehensive manner.
• Adjudicating claims that have the greatest complexity and severity, with the highest exposure to the company and to the insured, which may include excess umbrella policies.
• Managing diary timely and complete tasks to ensure that cases move to the best financial outcome and timely resolution.
• Completion of claim evaluations with settlement authority recommendations and present those recommendations to upper management.
• Identifying, assigning, and coordinating the assignment and coordination of expertise resources to assist in case resolution.
• Negotiation of claims to a proper resolution within the authority extended.
• Attend mediations if as and when required.
• Handling all fatality and pedestrian losses.
• Proactively move files toward a proper resolution.
• Establish and maintain an appropriate diary on all files.
• Consult with defense counsel or medical experts if needed.
• Applies cost containment methodology, when appropriate, claim review for medical necessity and reasonable and customary charges.
• Utilizing third party bill reviews when applicable.
• Report to Underwriting when information is developed requiring a risk analysis of the policy.
• Communicate with agents, providing updates, inquiries…