RolePurpose The Finacial Lines Claims Adjusteris responsible to manage a mixture of Financial Institutions (FI), Errors &Omissions (E&O) and Directors & Officers claims, from notification toresolution of claims, including coverage analysis, legal liability, quantumanalysis, reserving, communication, documentation, litigation management,evaluation, negotiation and settlement. KeyResponsibilities Exercise proper judgment anddecision making to analyze the claims exposure to determine the course ofaction and negotiate and settle the claim with first and third party claimants,authorizing claims payments and reserves in accordance with policy provisionsand applicable law to ensure service standards are maintained. Support the Claims Managementteam by providing quality claims handling and superior customer serviceensuring that the claims function runs effectively as well as work closely withunderwriters providing feedback on claims issues, wording and market trends. Ensure compliance with bestpractice for all aspects of claims assessment/handling including identify andreview suspect/fraudulent claims on a consistent basis as well as activelypromote and demonstrate principles of treating customers fairly. Work collaboratively with otherbusiness functions, brokers and external providers to develop and maintaineffective relationships to gather technical information for the benefit of theclaims function. Assist the Financial LinesSupervisor with larger and more complex claims when required. Liaise with external providers,monitoring the quality and costs of services provided to ensure that highservice standards are met as well as foster good relationships with internaland external customers and drive excellent customer service. Perform specials projectsand other related duties as assigned. Requirements Bacherlor'sDegree in Business Administration or Finance. Juris Doctor, preferable. Valid adjuster's license issued by the PR Insurance Commissioner Office,preferable. Stronganalytical decision making and problem-solving skills. Abilityto plan, organize and prioritize while working in a constant changingenvironment. Solidunderstanding of the claims legal process and quantum with knowledge of theCivil Procedure Rules. Demonstrate flexibility and adaptability to work in afast moving and challenging environment. Proficientin MS (Word, Excel and Power Point). Strong skills of database applications related to claims services. Intermediateknowledge of the structure and content of the English and Spanish Language. SDL2017
