Senior Claim Specialist

Key Responsibilities

• Investigate, evaluate, and manage complex or high-severity casualty claims, including coverage analysis, liability determination, and damages assessment.
• Evaluate and establish appropriate case reserves; authorize settlements within designated authority levels and recommend actions for cases exceeding authority.
• Negotiate and execute timely, fair, and equitable claim resolutions in accordance with company guidelines and jurisdictional requirements.
• Manage litigated files, including:
• Assigning cases to approved defense counsel
• Providing strategic direction and oversight
• Monitoring legal performance, budgets, and outcomes
• Attending mediations, settlement conferences, pre-trials, and trials as required
• Review and approve legal invoices to ensure accuracy and adherence to Litigation Management Program standards.

Customer & Stakeholder Service

• Deliver responsive, professional claim service to insureds, claimants, brokers, and business partners.
• Maintain proactive communication throughout the life of the claim to ensure transparency and compliance with regulatory expectations.
• Support client-facing activities, including claim reviews, presentations, and partnership meetings with underwriting and distribution teams.

Regulatory Compliance & Operational Excellence

• Ensure full compliance with state and federal regulations, including Fair Claims Practices Acts.
• Maintain accurate, timely claim documentation and reporting in accordance with MSMM guidelines and statutory requirements.
• Submit required data to regulatory agencies and internal stakeholders.
• Maintain active adjuster licenses and complete continuing education requirements.
• Prepare and deliver regular updates to Home Office and senior stakeholders on claim developments and strategies.
• Participate in special projects, process improvements, and departmental initiatives.

Qualifications

• Bachelor’s degree preferred
• Minimum of 7 years of experience handling complex casualty/liability claims, including litigated matters
• Demonstrated expertise in coverage analysis, litigation management, and claim negotiation