ERGO NEXT
Claims Specialist
RemoteNot specified. Estimate: United States · 90% confidence
- Experience
- Lead
- Employment
- Full-time
$100k–$130k/yr
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The listing doesn't say where it hires from. It may hire in United States (90% confidence). This is an estimate, not an eligibility rule; verify before applying.Signals: employment terms and salary level.
No BS summary
Lead-level Claims Specialist with 10+ years of commercial general liability and litigation experience to handle high-severity, high-complexity claims. Must have, or be able to promptly obtain, a Texas Independent Adjuster License and work US jurisdictions. Remote, full-time role across US locations.
Core skills
Commercial General LiabilityLitigation
Optional skills
Advanced studiesInsurance designation
What you'll do
- Extensive policy document and legal contract interpretation
- Ability to analyze and identify coverage and related coverage issues
- Leverage a working knowledge of insurance contracts, Unfair Claims Settlement Practices, insurance codes, civil codes, vehicle codes, arbitration rules and regulations, tort law, claims best practices handling and management as part of ongoing adjudication of claims
- Manage, investigate, and resolve claims within prescribed authority levels
- Recommend ultimate resolution on assigned cases in excess of authority to claims management
- Drive litigation; attend mediations, trials, and other alternative dispute resolution avenues
- Communicate with policyholders, witnesses, and claimants to gather information and refer tasks to auxiliary resources as necessary
- Preemptively communicate and respond to written (email, SMS, fax, mail) and telephone inquiries, including status reports
- Present file materials for authority and roundtables
- Work with nurses, doctors, and attorneys on file reviews
- Comply with all statutory and regulatory requirements of all applicable jurisdictions
- Meet detailed quality assurance standards and meet set goals for performance
- Set and revise case reserves in accordance with the reserving policy
- Identify potentially suspicious claims and refer to SIU; identify opportunities for third-party subrogation
- Be accountable for the security of the financial processing of claims and security of information contained in claims files
- Work with, and provide claim-specific guidance to, independent field adjusters
- Partner closely with internal teams and advise leadership of key claim activities and exposures
What they require
- BS/BA Degree required
- Preferred: Advanced studies or insurance designation
- At least 10+ years of directly related experience with Commercial General Liability and Litigation
- Strong written and oral communication skills required, as well as strong interpersonal, analytical, investigative, and negotiation skills
- In-depth knowledge of multi-jurisdictional claims handling issues
- Willingness to utilize and adapt to evolving technologies within the Claims operations
- Must be a self-starter and able to work independently
- Candidates must have, or be able to promptly obtain, a Texas Independent Adjuster License
- Proven success in delivering strong results in a rapidly changing claims environment
- Ability to collaborate with cross-functional teams to achieve business results
- Someone who achieves a standard of excellence with work processes and outcomes, honoring company policies and regulatory compliance
- Team orientation that emphasizes building strong working relationships and contributing to a positive work environment
- Receptivity to feedback and a willingness to learn, embracing continuous improvement
- Some travel capability, likely up to 10%
Benefits
- Potential eligibility for annual performance-based incentive program
- Partially subsidized medical plan
- Fully subsidized vision/dental options
- Life insurance
- Disability insurance
- 401(k)
- Flexible paid time off
- Parental leave
ERGO NEXT's mission is to help entrepreneurs thrive by building a technology-led, full-stack provider of small business insurance. Since 2016, it has helped hundreds of thousands of small business customers across the United States get fast, customized and affordable coverage.
InsurTechStartup
$100k–$130k/yr