Risk Management Specialist

SUMMARY:

This role is responsible for managing a wide range of claims, including bodily injury liability (from low to high severity), property damage, and product-related incidents. Responsibilities include efficient retention and transfer of claims, along with timely and professional communication with third parties, insurers, and legal representatives. File retention volumes can fluctuate and may exceed 150 active claims at any given time, requiring strong organizational, time mangement and prioritization skills.

SPECIFIC RESPONSIBILITIES:

- Independently manage, gather, and critically analyze investigative materials and evidence related to all assigned incidents, ensuring thorough documentation and informed decision-making.
- Facilitate effective collaboration and communication with location managers to ensure timely participation, accurate reporting, and the successful completion of defense documentation. Provide coordinated support to both internal and external stakeholders throughout the claims process.
- Review contractual agreements, relevant case law, and internal policies to support informed assessments and strategic claims handling decisions.
- Evaluate and implement strategic approaches to claim response, including recommendations for retention, transfer, denial, or settlement, based on case specifics and organizational guidelines.
- Resolve, deny, transfer, or escalate liability claims as appropriate, while developing comprehensive defense files in preparation for potential litigation. Provide ongoing support and guidance to assigned adjusters and legal counsel throughout the claims process.
- Negotiate and finalize claim settlements with plaintiffs or their legal representatives, insurers, adjusters, and third parties, in accordance with delegated authority from the Manager.
- Substantiate and negotiate property claims by engaging directly with at-fault third parties or coordinating with assigned third-party administrators to ensure fair and timely resolution.
- Review and update independent adjusters’ reports, defense counsel correspondence, initial legal opinions, discovery reports, and subsequent updates. Provide clear recommendations, comments, and direction on files as needed to support effective claims management.
- Educate location managers on claim programs, policies, and procedures, including incident reporting, investigation protocols, litigation management, resolution strategies, and the effective delivery of claim-related information.
- Ensure the integrity and accuracy of the claims database by maintaining up-to-date details, reserve amounts, and claim status. This includes vigilant oversight of data entry and timely updates to support informed decision-making and reliable reporting.
- Provide direct supervision and leadership in the performance management of the Risk Management Administrator, including goal setting, coaching, feedback, and development planning to ensure operational excellence and continuous improvement.
- Continuously monitor and analyze legal opinions, claims costs, and exposure data to identify patterns, emerging risks and trends. Apply root cause analysis to uncover underlying factors contributing to claim frequency or severity, and collaborate with management team to develop targeted mitigation strategies. This insight-driven approach supports proactive risk management, enhances operational efficiency, and informs future policy and procedural improvements.
- Conduct analysis to identify opportunities for improvement in existing claims programs and procedures. Develop and present recommendations for enhancements or new initiatives, and support the implementation of approved changes to ensure alignment with operational goals and best practices.

QUALIFICATIONS:

• Post-secondary education in Business, Insurance, Risk Management, or a related field.
  - 2 – 4 years of experience in claims handling, insurance, or risk management
  - Professional designations such as CIP, CRM, or equivalent (preferred).
  - Proven experience managing bodily injury, property damage, and product liability claims across varying severity levels.
  - Strong understanding of legal processes, including litigation, discovery, and defense strategy.
  - Experience working with third-party administrators, insurers, and legal counsel.
  - Experience with Claims Management Systems
  - Familiarity with contractual review, case law interpretation, and policy analysis.
  - Intermediate skills in MS Office and Outlook
  - Attention to detail, decision making and documentation and reporting abilities, ability to manage change, analytical thinking, strong communication skills and customer focused  

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