Licensed Claims Specialist Lead

Job Summary

Working remotely, the full-time Licensed Claims Specialist Lead will independently conduct detailed analysis of complex auto liability medical claims, recommend settlement strategies, and mentor lower-level adjusters while ensuring compliance with corporate policies and regulations.

Key responsibilities

• Investigate, evaluate, and resolve complex major claims, applying analytical skills for informed decision-making
• Create reservation of rights and coverage denial letters, negotiating settlements directly with involved parties
• Document and communicate claim activity efficiently to support positive outcomes for claims files

Required qualifications

• High school diploma
• 12 or more years of related claims experience with a proven track record at a senior adjuster level
• Appropriately licensed and/or certified in all states where claims are handled
• Knowledge of accepted industry standards and practices
• Computer experience with related claims and business software