Provide customer service, dispute resolution, education and general claims consultation services to all assigned captive clients. Help support our TPA partners in successful claims administration.
ESSENTIAL EDUCATION AND EXPERIENCE:
Bachelor’s Degree or equivalency in a related discipline and at least five (5) years of experience in WC and P&C claims handling and/or claims customer service and have experience in face-to-face and telephonic client contact as it relates to commercial claims.
SKILLS/COMPETENCIES REQUIREMENTS:
- Strong team attitude.
- Works well independently and in a team environment.
- Interpersonal skills.
- Maturity.
- Excellent written and verbal communication skills.
- Proficient in Microsoft Office, especially using Excel and Powerpoint, and other on-line computer systems.
- Comfortable making presentations to small and large groups.
- Organization, planning and prioritization skills.
- Strong analytical, problem solving and judgment skills.
- Strong customer service orientation.
- Commitment to company values.
- Willingness and ability to travel as required.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Monitor the claim service program of each client on an as needed and ongoing basis.
- Monitor the claims handling on specific serious or sensitive claims.
- Act as liaison between the client, the broker and claims administrator on any claim matter.
- Work closely with captive members to help reduce reserves and expenses.
- Monitor large value claims and other claims as requested by client.
- Coordinate and participate in claim review meetings for all clients.
- Make sure adjusters are complying with all special handling instructions.
- Create and generate claims reports on an as needed or as requested basis.
- Set up new clients with the claims administrator and train new clients on the processes needed for each captive program.
- Analyze the service requirements of each individual captive member and work with the claims administrator to achieve compliance.
PRIORITIES:
Customer Service/Relationships, Vendor Relationships, Positive Team Attitude
