Complex Loss Specialist

This is a Fully Remote Job About Our Client:Integrated Specialty Coverages, LLC is a technology and data-driven commercial Managing General Agent and insurance wholesaler operating in the insurance industry. Supported by a leading private equity firm, the organization integrates insurance and technology to innovate in online insurance distribution, serving various industries and small businesses. The company emphasizes a digitally focused approach that leverages user experience, data, and AI/ML to enhance engagement with brokers, agents, and customers. About the Opportunity:The COMPLEX LOSS SPECIALIST role focuses on managing the most complex, high-exposure insurance claims requiring advanced technical expertise and negotiation skills. Reporting to supervisory management, this position involves leading strategic discussions, providing in-depth analysis, and determining optimal resolution strategies for challenging claims. The role is critical in ensuring effective claim resolutions and supporting the claims management team. Responsibilities:Demonstrate teamwork, motivation, and positive behavior to meet objectivesBuild and maintain productive relationships with internal and external stakeholdersResearch and document applicable insurance coverage detailsIdentify and resolve coverage questions; prepare reservation of rights and denial documentsInvestigate loss facts through statements and supporting documentationDocument claim activities accuratelyApply legal liability judgment; exercise settlement authority within limitsAssign and oversee defense counsel, adjusters, and expertsIdentify claims exceeding authority and escalate appropriatelyEvaluate and recommend claim reservesPrepare reports in compliance with company policiesHandle claims following Fair Claims Practices rulesProvide regular updates to insureds, claimants, underwriters, and carriersConsult with supervisors on unique or complex claims Core Technical Duties:Investigate and evaluate healthcare liability claims including medical malpractice and professional liabilityAnalyze and interpret insurance policiesDraft coverage-related communications for supervisory reviewManage litigation assignments and activities Investigation & Documentation:Obtain recorded and written statementsGather and organize supporting documentsMaintain detailed and compliant claim filesPrepare written reports and roundtable summaries Requirements:Minimum 10 years of claims experience with complex claims focusCollege degree or equivalent claims management experiencePreferred 10 years litigation management experienceValid individual adjusting license for designated home state; willingness to obtain additional licensesActive adjusters license in own nameProficient with Microsoft Outlook, Word, and ExcelEffective communication skills with leadership and external contacts Pay Range and Compensation Package:National pay range $87,000—$109,000 USDComprehensive benefits including medical, dental, vision insurance, 401(k) plan with match, paid time off, and others Benefits & Perks:Employee ownership programProfessional development opportunitiesOwner referral programWork from home reimbursement for remote/hybrid rolesEmergency financial assistance Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note:TalentHop is not the Employer of Record (EOR) for this role. Our purpose in this opportunity is to connect exceptional candidates with leading employers. We help job seekers worldwide discover roles that match their goals and guide them to complete their full application directly through the hiring company's career page or ATS.