- Manage and oversee complex property, catastrophe, liability, auto, and workers' compensation claims.
- Evaluate claim investigations, reserves, settlement recommendations, and coverage determinations.
- Analyze claim documentation and supporting evidence to ensure appropriate claim outcomes.
- Provide recommendations regarding claim strategy, coverage application, and settlement opportunities.
- Maintain settlement authority up to assigned limits and provide recommendations on higher-exposure claims.
- Lead the review and management of catastrophe and large-loss property claims.
- Coordinate with carriers, TPAs, consultants, engineers, and forensic accounting firms.
- Review business interruption analyses and property damage valuations.
- Assist in claim preparation, documentation, and negotiation efforts.
- Support disaster response activities and claim recovery initiatives.
- Serve as a liaison with TPAs, carriers, brokers, attorneys, and external vendors.
- Challenge claim decisions, reserve positions, and coverage interpretations when appropriate.
- Monitor TPA performance and ensure adherence to service expectations.
- Negotiate favorable claim outcomes on behalf of the organization.
- Serve as a technical resource and trusted advisor for leadership and team members.
- Communicate clear expectations on claims packages to internal field teams and external vendors.
- Provide guidance and mentoring to less experienced claims professionals.
- Identify emerging claim trends and recommend proactive risk mitigation strategies.
- Participate in strategic planning discussions regarding claims management and risk financing.
- Identify opportunities to improve claims processes, workflows, and reporting.
- Assist in the development and implementation of claims KPIs and performance metrics.
- Support technology initiatives and workflow optimization efforts in support of claims and policy management.
- Contribute to the creation and maintenance of standard operating procedures and best practices.
Requirements
- Bachelor's degree or equivalent combination of education and experience.
- Minimum 8 years of progressive insurance claims experience.
- Demonstrated experience handling complex property and casualty claims.
- Strong understanding of insurance policy interpretation and coverage analysis.
- Experience managing relationships with TPAs, carriers, brokers, and legal counsel.
- Excellent negotiation, communication, and analytical skills.
- Ability to manage multiple priorities in a fast-paced environment.
- Preferred 10+ years of insurance claims experience.
- Catastrophe and large-loss property claims experience.
- Business interruption claims experience.
- Experience within real estate, property management, multifamily, or large portfolio environments.
- Self-insured retention program experience.
- Texas All-Lines Adjuster License.
- Professional designations such as AIC, CPCU, ARM, CIC, or SCLA.
- Experience developing KPIs, dashboards, and process improvement initiatives.
Core Competencies
Demonstrates extensive experience in managing complex property and casualty claims, with a strong focus on negotiation, coverage analysis, and relationship management with TPAs, carriers, and legal counsel. Proficient in developing KPIs and optimizing claims processes to enhance operational efficiency.
Highest-signal resume keywords
- Complex Property And Casualty Claims Management
- Insurance Policy Interpretation
- Negotiation Skills
- KPI Development
- Texas All-Lines Adjuster License
ATS Optimization Keywords
Hard Skills
- Claims Evaluation
- Coverage Determination
- Settlement Recommendations
- Business Interruption Claims
- Catastrophe Claims Management
- Claims Documentation
- Analytical Skills
- Risk Mitigation Strategies
- Process Improvement Initiatives
- Workflow Optimization
Soft Skills
- Communication Skills
- Mentoring
- Relationship Management
- Analytical Thinking
- Prioritization
Certifications & Qualifications
- AIC
- CPCU
- ARM
- CIC
- SCLA
Industry Keywords
- Insurance Claims
- TPA Management
- Property Management
- Real Estate
- Large Portfolio Environments