Claims Specialist

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

Benefits offered by this job

Health insurance

401K with employer matching

PTO and paid holidays

Hybrid work model

Casual office environment

Job summary

Sovereign Insurance Group is seeking a Claims Specialist to manage the full claims process from notice to resolution. You will collaborate with customers and carriers, maintaining thorough records and timely communication throughout the life of each claim.

The role requires licensure or ability to obtain a Property & Casualty license, strong analytical skills, and proficiency with MS Office and claims systems. Hybrid work options are available in Berwyn, PA.

Qualifications

• Requires license (Property & Casualty) or ability to obtain one; agency may assist.
• Proficiency with Microsoft Office Suite.
• Familiarity with AMS360 and ImageRight or ability to learn quickly.
• Strong analytical and detailed communication skills.
• Solid understanding of industry processes and regulations.
• Excellent communication with leadership, coworkers, insureds, and carriers.
• Ability to work independently with minimal supervision.
• Professional interpersonal skills across diverse personalities.
• Excellent organization and attention to detail.
• Team-oriented with openness to feedback.

Responsibilities

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

Skills

MS Office

AMS360

ImageRight

Analytical mindset

Independent worker

Strong communication

Education

Bachelor's degree in business/insurance

Claims investigation background

Tools

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.