Claims Specialist

Sovereign Insurance Group; Berwyn (PA); Hybrid; USD 70,000 - 85,000; Full time

Benefits offered by this job

Health insurance

Vision & Dental insurance

Life insurance

Employer-sponsored HSA

401K with employer matching

PTO and paid holidays

Hybrid opportunities in Berwyn, PA

Remote opportunities in PA or NJ

Job summary

Sovereign Insurance Group is seeking a Claims Specialist to manage the claims lifecycle from notice to resolution. The role collaborates with customers and carriers to ensure a smooth process, with emphasis on accuracy, communication, and regulatory adherence.

The position requires a valid P&C license or ability to obtain one, strong MS Office skills, and experience in claims investigation. Hybrid work options are available in Berwyn, PA, with remote opportunities in PA/NJ.

Qualifications

• Valid Property & Casualty license or the ability to obtain one.
• Bachelor's degree in business or equivalent insurance industry experience.
• Strong proficiency with Microsoft Office Suite and ability to learn AMS360 and ImageRight.

Responsibilities

• Review and process incoming claims timely and accurately in accordance with regulatory and company requirements.
• Request and track qualifying information from customers for accurate claim submission.
• Investigate and resolve complex claim issues.
• Maintain detailed records of all claims activity and correspondence.
• Communicate with customers and carriers to update on claim status and next steps.
• Track large claims and keep insured informed from notification to closure.
• Notify SVP Operations of large claim concerns.
• Provide excellent customer service addressing concerns and complaints.
• Analyze and investigate complicated insurance claims to help prevent fraud.
• Generate monthly, quarterly, and yearly loss run reports for stakeholders and leadership.
• Perform other duties as assigned.

Skills

Property & Casualty license

Microsoft Office

AMS360

ImageRight

Analytical skills

Communication skills

Regulatory knowledge

Independent work

Interpersonal skills

Organizational skills

Team player

Education

Bachelor's degree in business-related field

Experience in claims investigation (commercial property & casualty)

Tools

Excel

AMS360

ImageRight

Job description

The Claims Specialist is responsible for maintaining the company claims process from initial notice to resolution. This person in this position works closely with customers and insurance carriers, providing support and guidance to ensure a seamless experience throughout the claims process.

Responsibilities

• Review and process incoming claims in a timely and accurate manner, in accordance with all regulatory and company requirements.
• Request and track any qualifying information needed from customers for accurate claim submission.
• Investigate and resolve complex claim issues.
• Maintain detailed records of all claims activity, including all correspondence and relevant findings.
• Communicate clearly and regularly with customers and carriers to ensure all parties are aware of claims’ status and next steps.
• Track and review large claims, maintaining consistent claim awareness, and ensuring insured is continuously informed of claim status from initial notification to claim closure.
• Notify SVP Operations of large claim concerns and/or issues.
• Provide excellent customer service in addressing customer concerns and complaints.
• Analyze and investigate complicated insurance claims to help prevent fraud.
• Generate monthly, quarterly, and yearly loss run reports for external stakeholders and the internal Leadership team.
• Perform other duties as assigned or required.
  

Required Skills/Abilities

• A valid resident Property & Casualty insurance license is required; or the ability to obtain and maintain a valid state insurance license (agency may assist)
• Strong proficiency with Microsoft Office Suite
• Knowledge of, or ability to quickly learn, AMS360 and ImageRight.
• Strong analytical skills and an inherent knack for detailed and comprehensive communication.
• Sound grasp of industry processes and existing business regulations.
• Excellent communication skills with leadership, coworkers, insureds, and carriers.
• Ability to work independently with minimum supervision.
• Professional and tactful interpersonal skills with the ability to interact with a variety of personalities.
• Excellent organizational skills and attention to detail.
• Ability to work within a team atmosphere with a willingness to ask for and receive feedback at all levels.
  

Education and Experience

• Bachelor's degree in a business-related program or equivalent experience in the insurance industry
• Background in claims investigation and commercial property & casualty insurance preferred
  

Benefits

• Salary: $70,000-$85,000 annually
• Health insurance, vision, dental, life insurance, and more. This includes an employer-sponsored HSA, paid coverage for employees, and cost-sharing for families.
• 401K with employer matching.
• PTO and paid holidays tosupport work-life balance. PTO is based on experience and is expected to increase over time.
• A casual office environment with a dedicated and professional team.
• Hybrid opportunities in Berwyn, PA
• Remote opportunities in PA or NJ