General Liability Attorney Represented Claims Specialist Publix Super Markets, Inc. - 3.9 Lakeland, FL Job Details Full-time 4 hours ago Qualifications Risk transfer Medicare Insurance dispute resolution Regulatory compliance in claims processing Claims negotiation Mid-level Medicare regulations Risk analysis Liability insurance knowledge Insurance investigations Case referral Insurance claims fraud prevention Subrogation claims Managing litigation projects Litigation response management Full Job Description The General Liability Attorney Represented Claims Specialist (Claims Specialist) adjusts non-litigated general liability and fleet claims with both non represented customers and attorneys. This role includes gathering evidence, analyzing facts, investigating, and using sound judgement for both non-litigated attorney represented claims and customer claims to determine Publix's liability exposure. The Claims Specialist communicates directly with customers and attorneys, directly negotiating settlements on low to mid-level general liability and fleet claims. This position is also responsible for preliminarily identifying subrogation opportunities and appropriately referring claims to third parties with potential liability exposure when appropriate or escalating the subrogation or tender issue to a Supervisor. There are approximately 21,000 events reported annually. Of those 21,000 events, approximately 8,100 become claims. The Claims Specialist also exclusively handles Fleet, CQA, QRE and Crime and Casualty events regardless of whether they escalate to a claim. Customer claims cost $2,200 to resolve on average. Attorney-represented claims duration is 13 months on average and cost $35,000 to resolve. Total inventory of active GL claims fluctuates between 2,500 - 2,800 with approximately 1,200 of the total open claims in litigation in all states that Publix does business. Each associate will process approximately 250 new attorney-represented claims a year while working a desk of approximately 175 active customer incidents. The responsibilities listed on this position analysis are not intended to be all-inclusive and additional responsibilities may be assigned as needed.

Responsibilities include:

analyzing, investigating, and adjusting asserted non-attorney represented customer claims and attorney represented customer claims to a resolution for evaluating and completing potential risk transfer referrals and overseeing the administrative functions involved in the resolution of non-attorney represented customers claims and resolution of claim subrogation against third parties review and analysis of the demand package received from opposing counsel and the negotiation/settlement of claims when appropriate, complying with federally mandated Medicare reporting on settled claims developing an action plan for effectively managing low value (below $50,000) litigated claims during handling process identifying specific types of liability claims that may be suspicious, repetitive in cause, of a sensitive nature, or claims representing heightened financial exposure to Publix