Associate Claims Services Manager

Captive Resources, LLC; Itasca (IL); Remote; USD 75,000 - 95,000; Full time

Job summary

A leading company in claims consulting is seeking a professional to provide customer service and claims consultation for captive clients. The ideal candidate will have a Bachelor’s degree and at least five years of experience in claims handling. Key responsibilities include overseeing claims services, member education, and addressing queries related to claims management.

Benefits

Medical, dental, and vision benefits

401(k)

Life and AD&D insurance

Short-term and long-term disability

Educational assistance programs

Qualifications

• Bachelor’s Degree or equivalency in a related discipline.
• At least five (5) years of experience in WC or P&C claims handling.
• Experience in client contact as it relates to commercial claims.

Responsibilities

• Oversee claims services provided by TPA and Carrier partners.
• Address member questions and concerns with claims handling.
• Support member education and training as well as hosting workshops.

Skills

Interpersonal skills

Analytical skills

Problem solving

Communication skills

Organizational skills

Education

Bachelor’s Degree

Tools

Microsoft Office

Claims RMIS systems

Job description

Remote
1100 N Arlington Heights Rd
Itasca, IL 60143, USA

Remote
1100 N Arlington Heights Rd
Itasca, IL 60143, USA

• Pay or shift range: $75,000 USD to $95,000 USD
  
  The estimated range is the budgeted amount for this position. Final offers are based on various factors, including skill set, experience, location, qualifications and other job-related reasons. Our benefits include medical, dental, vision, Rx, 401(k), life and AD&D, short-term and long-term disability, and more. Please visit our website for more information.

Description

Provide customer service, dispute resolution, education and general claims consultation services to all assigned captive clients (members). 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 or 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:

• Works well independently and in a team environment.
• Excellent interpersonal and written and verbal communication skills.
• Proficient in Microsoft Office, especially using Excel and Powerpoint, and ability to use Claims RMIS systems.
• Comfortable making presentations to small and large groups.
• Organization, planning and prioritization skills.
• Strong analytical, problem solving and judgment skills.
• Commitment to company values.
• Willingness and ability to travel as required to support domestic client workshops and some international travel for board meetings. Generally, travel dates are known and planned well in advance.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Oversee claims services provided by TPA and Carrier partners and evaluate and manage member satisfaction with claims handling.
• Address member questions and concerns with claims handling through working with adjusters and claims account management; and, where appropriate, work with CRI vendor management.
• Support member education and training by planning, coordinating other speakers, and ability to present on claims topics as well as supporting/hosting workshops.
• Ability to report to captive board members on claims matters at board meetings, as well as manage member satisfaction with claims handling.
• Set up new clients with the claims administrator and conduct appropriate onboarding on the captive claims processes and resources available.
• 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 clients to drive engagement on claims and their appropriate use of available claims tools and resources including managing claims expenses.
• Monitor large value claims and other claims as requested by client.
• Notify CRI captive team of significant claims related issues and participate in captive team meetings.
• Participate in department projects and support initiatives.
• Coordinate and participate in claim review meetings.
• Ensure adjusters are complying with all special handling instructions.
• Create and generate claims reports on an as needed or as requested basis.
• Analyze the service requirements of each individual captive member and work with the claims administrator to achieve compliance.

PRIORITIES: Customer Service/Relationships, Vendor Relationships, Problem Solving, Positive Team Attitude

Qualifications

Skills

Behaviors

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Motivations

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Education

Experience

Licenses & Certifications

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.