Major Case Specialist

We are seeking an accomplished Major Case Specialist to join our Claims Casualty team. In this highly impactful role, you will manage pre-suit, non-litigated, complex, high-exposure casualty claims involving bodily injury, construction defect, and property damage. You will bring advanced technical claim-handling expertise, sound judgment, and a proactive approach to investigations, coverage analysis, reserve evaluation, settlement strategy, and negotiations. This is an opportunity for an experienced claims professional to influence outcomes, collaborate with trusted internal and external partners, and help deliver fair, timely, and cost-effective resolutions.

What You’ll Do:

1. Manages a pending of complex and high-severity claims from assignment through resolution, including investigation, coverage analysis, liability assessment, damage evaluation, negotiation and settlement.
2. Analyzes policy language, endorsements, exclusions, coverage positions, liability facts, damages, and jurisdictional considerations to determine appropriate claim strategy.

1. Develops, documents, and executes claim resolution plans that align with company objectives, best practices, legal requirements, and fair claim-handling principles.
2. Establishes and maintains accurate reserves based on exposure analysis, legal developments, medical information, damages evaluation, and anticipated expense.
3. Directs and collaborates with defense counsel, experts, vendors, investigators, medical professionals, and other business partners to support effective claim resolution.
4. Evaluates settlement opportunities, participates in mediations, settlement conferences, and negotiations, and provides authority recommendations supported by clear analysis.
5. Communicates claims strategy, coverage positions, reserve rationale, and significant developments to management, underwriting, agents, insureds, reinsurers, and other stakeholders as appropriate.
6. Ensures claim files are thoroughly documented, timely updates, and handled in accordance with company procedures, quality standards, statutory requirements, and regulatory obligations.
7. Identifies opportunities for subrogation, contribution, indemnity, risk transfer, fraud referral, or other recovery strategies when applicable.
8. Provides technical guidance, coaching, and mentoring to less experienced claim professionals on complex casualty matters.
9. Participates in claim reviews, audits, roundtables, quality initiatives, projects, and process improvement efforts.
10. Performs other duties as assigned.

What We’re Looking For:

The ideal candidate is a seasoned casualty claims professional who combines deep technical expertise with strong analytical judgment, clear communication, and the ability to collaborate effectively with attorneys, experts, insureds, agents, reinsurers, and business partners. You are comfortable managing high-severity matters independently while keeping stakeholders informed and claim strategies moving forward.

Qualifications:

More than 10 years of experience in a related claims role, or an equivalent combination of education and experience, is required. Experience handling complex casualty claims, bodily injury matters, construction defect claims, property damage claims, litigated files, coverage analysis, reserve evaluations, and settlement negotiations is strongly preferred.

Licenses and Designations:

Various state adjusters’ licenses are required. CPCU, AIC, or other related professional designation is preferred.

Why Join Us?

This role offers the opportunity to work on meaningful, high-impact claim matters in a collaborative environment where technical expertise, thoughtful decision-making, and professional growth are valued. You will contribute to fair claim outcomes, support strong business partnerships, and serve as a trusted resource on complex casualty issues.

Work Environment and Physical Demands:

This position primarily operates in a professional remote work environment. The role routinely uses standard office equipment such as computers, telephones, and other digital communication tools.

The physical demands described here are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions.

• Prolonged periods of sitting at a desk and working on a computer
• Frequent use of hands and fingers to operate a computer, keyboard, and other office equipment
• Occasional standing, walking, bending, or reaching
• Ability to exchange accurate information with others through verbal, written, and electronic communication methods
• Ability to view and interpret information on a computer screen and in written materials
• Occasionally may need to lift or move items up to 10 pounds

The work environment is generally quiet with moderate noise levels typical of an office setting.

We are an equal opportunity employer and welcome qualified applicants from all backgrounds. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this role.