Assistant Claims Examiner Jobs in Rome, NY (NOW HIRING)

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The Large Loss Director is a technical individual contributor responsible for the oversight, consultation, and resolution of the most complex and catastrophic workers' compensation claims. This individual contributor role provides company-wide influence and leadership in the interpretation of complex policy coverages, litigation management, reserving, claim resolution strategies, regulatory compliance, and large loss methodologies.
Working closely with claims leadership, disposition consultants, legal services, customers, brokers, and business partners, the Large Loss Director drives superior claim outcomes, technical excellence, operational effectiveness, and profitable growth while serving as a mentor and resource to claims professionals across the organization.
The ideal candidate will have extensive workers' compensation claims experience with significant responsibility handling highly complex and catastrophic claims.

JOB DESCRIPTION:

Essential Duties & Responsibilities
Performs a combination of duties in accordance with departmental guidelines:

• Oversees the most complex, high-exposure, catastrophic, and litigated workers' compensation claims. Serves as the technical authority on claim coverage, liability, compensability, exposure evaluation, reserving, and settlement strategy. Determines if a major claim should be settled or litigated and implements an appropriate resolution strategy accordingly. Effectively manages loss costs and claim expenses on major claims.
• Develop and execute resolution strategies that balance customer needs, claim outcomes, and cost management objectives. Direct complex investigations, litigation activities, discovery strategies, and settlement negotiations. Collaborate with staff and panel counsel to develop effective litigation and resolution strategies.
• Provide expert guidance regarding Medicare Set-Asides, Independent Medical Examinations, rated age evaluations, catastrophic injury claims, and other specialized claim issues.
• Review and provide direction on large loss claims across the organization.
• Ensure timely review and approval of reserve analyses and Large Loss Summary Reports.
• Identify emerging severity exposures and recommend claim transfers, disposition involvement, or specialized resources when appropriate.
• Lead and participate in formal claim roundtables focused on large loss claims, reserving accuracy, and resolution planning.
• Analyze complex claim trends and communicate actionable recommendations to senior leadership.
• Actively pursues and identifies ways to reduce inefficiencies in claims processes.
• Utilizes oral presentation and writing skills to escalate or efficiently communicate appropriate exposures to senior claims management and other internal business partners, as needed.
• Keeps current on state/territory regulations and issues industry activity and trends. May represent company in industry trade groups or other important events involving external business partners and clients.
• Serve as a mentor, coach, and technical resource for claims professionals, managers, and business partners.
• Responsible for special claims projects and presentations.
• Identifies trends in complex claims and settlement strategies and communicates to senior management.

Reporting Relationship
Director or above

Skills, Knowledge and Abilities

• The highest level of technical and product specific expertise, claims resolution skill and knowledge of insurance and claims principles, practices and procedures.
• Excellent communication, negotiation and presentation skills. Ability to effectively interact with all levels of CNA's internal and external business partners.
• Excellent analytical and problem solving skills, with the ability to manage multiple projects.
• Ability to exercise independent judgment to effectively evaluate and handle ambiguous situations and issues as well as analyze, distill and communicate important aspects of them succinctly.
• Creativity in resolving unique and challenging business problems.
• Ability to achieve results by taking a proactive long-term view of business goals and objectives.
• Knowledge of Microsoft Office Suite and other business-related software and company systems.
• Ability to embrace change and value diverse opinions and ideas.
• Effectively manages multiple projects.
• Ability to articulate complex claim facts, issues and analyses in concise presentations to business partners and management as well as in internal reports.

Education and Experience

• Bachelor's degree or equivalent experience. Professional designations preferred.
• Typically a minimum 10 years claims experience with proven track record of success.

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In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $97,000 to $189,000 annually.Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visitcnabenefits.com.

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CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contactleaveadministration@cna.com