In this role, you will review, research, gather information, and respond to reviews and complaints for U.S. insurers, service contract companies, motor clubs, agency entities, and SBAC. You will assist with mediation, arbitration, and litigation, while engaging directly with Departments of Insurance, Better Business Bureau, Attorney General, insured individuals, appeals, law firms, regulatory agencies, and TPAs. Communicating trends to Compliance, Claims, Administration, Legal, and Internal Auditing teams is crucial for reducing risk. Your primary focus will be to professionally evaluate and respond to issues, protect the company’s image, safeguard assets, and mitigate regulatory actions and examinations.
Minimum Qualifications:
- Bachelor's degree preferred.
- 4+ years of Insurance, Claims Handling, and/or Dispute Resolution Experience.
- Property & Casualty (Specialty plans a plus).
- Life insurance experience.
- Insurance Complaint handling experience.
- Medical terminology familiarity.
Property & Casualty License (Adjuster) a plus.- Prior management/supervisor experience.
Primary Job Functions:
- Manage staff.
- Research, analyze, and respond to inquiries, litigation (mediation and arbitration), regulatory actions, complaints, appeals, etc. This includes claim decisions, objections, and appeals, premium charges, notices, refunds, claims against agents, customer service complaints and reviews, etc.
- Respond to complaints or inquiries.
- Reviews and prepares responses to subpoenas.
- Prepares file and assist in consumer litigation, mediation, and arbitration.
- Maintains and updates complaint and litigation logs.
- Prepares litigation and complaint reports.
- Identifies potential workflow improvements and impediments.
- Identifies trends and communicates to stakeholders to reduce risk.
- Think outside the box and review with a “what if” mindset.
- Other duties as assigned.
The above cited duties and responsibilities describe the general nature and level of work performed by people assigned to the job. They are not intended to be an exhaustive list of all the duties and responsibilities that an incumbent may be expected or asked to perform.
Skills & Competencies Required:
- Requires knowledge of a specialized function or skill.
- Developing real trade craft and skills.
- Letter writing experience with proper grammar, spelling and punctuation a must.
Additional Information:
Full benefit package including medical, dental, life, vision, company paid short/long term disability, 401(k), tuition assistance and more.
