Senior Technical Claims Specialist- New York Labor Law

A Brief Overview

We are looking for a highly capable Senior Technical New York Labor Law Claims Specialist to join our team and work from our New York City office on a hybrid basis. This role adjudicates our most complex New York labor law claims for our customers.

How You Will Make an Impact:

• Working with limited oversight under broad management direction, adjudicate highly complex claims, at the highest authority limits on assignments reflecting the highest degree of technical complexity, potentially with major impact on departmental results.
• Conducting detailed information gathering, analysis and investigation to find solutions to issues that are numerous and undefined.
• Reporting to senior management and underwriters on claims trends and developments.
• Investigating claims promptly and thoroughly
• Analyzing claims forms, policies and endorsements, client instructions, and other records to determine whether the loss falls within the policy coverage.
• Investigating claims promptly and thoroughly, including interviewing all involved parties.
• Managing claims in litigation
• Managing diary timely and complete tasks to ensure that cases move to the best financial outcome and timely resolution.
• Properly setting claim reserves, taking into account how different policy wordings impact the claims reserving process.
• Identifying, assigning, and coordinating the assignment and coordination of expertise resources to assist in case resolution.
• Preparing reports for file documentation
• Applying creative solutions which result in the best financial outcome.
• Negotiates highly complex settlement packages, sets reserves and authorizes payment within scope of authority, settling claims in most cost effective manner and ensuring timely issuance of disbursements.
• Processing mail and prioritizing workload.
• Completing telephone calls and written correspondence to/from various parties (insured, claimant, etc.).
• Having an appreciation and passion for strong claim management.

What We Need:

• Juris Doctor from an accredited law school is required. Licensed attorney, in good standing in at least one state court in the United States.
• A deep knowledge of claims adjudication is typically achieved through a minimum of seven years’ experience adjudicating claims with exposure of $100,000 or more.    
• Must have good business acumen (i.e. understand how an insurance company works and makes money, including how this role impacts both Argo Group and our customers’ ability to be profitable).
• Ability to regularly exercise discretion and independent judgment with respect to matters of significance. This role primarily faces problems and issues that are difficult and require an understanding of a broader set of issues.
• Must have excellent communication skills and the ability to build lasting relationships.
• Exhibit natural curiosity in order to consistently explore and consider all options and is not governed by conventional thinking.
• Desire to work in a fast-paced environment.
• Excellent evaluation and strategic skills required.
• Strong claim negotiation skills a must.
• Knows how claims reserving techniques are used and how to assess whether a claim reserve is accurate.
• Must possess a strong customer focus.
• Effective time management skills and ability to prioritize workload while handling multiple tasks and deadlines.
• Demonstrates innovative thinking and regularly shares ideas to help the team whenever possible
• Ability to articulate the financial value of your work at multiple responsibility levels inside our clients’ business which may include CEO.
• Demonstrates inner strength.  Has the courage to do the right thing and demonstrates it on a daily basis.
• Intellectual curiosity.  Consistently considers all options and is not governed by conventional thinking.
• Proficient in MS Office Suite and other business-related software.
• Polished and professional written and verbal communication skills in order to present information accurately and effectively.
• The ability to read and write English fluently is required.
• Must demonstrate a desire for continued professional development through continuing education and self-development opportunities.
• Licensed Claims Examiner (Based on state) Must possess or have ability to quickly obtain a license in each jurisdiction requiring a license to adjudicate first party claims within 120 Days