Claims Specialist

Sovereign Insurance Group; Tredyffrin Township (Chester County); Hybrid; USD 70,000 - 85,000; Full time

Benefits offered by this job

Health insurance

Vision insurance

Dental insurance

Life insurance

Employer-sponsored HSA

401K with employer matching

PTO and paid holidays

Casual office environment

Hybrid opportunities in Berwyn, PA

Remote opportunities in PA or NJ

Job summary

The Claims Specialist at Sovereign Insurance Group manages the claims process from notice to resolution, working closely with customers and carriers to provide guidance and a seamless experience. Responsibilities include timely processing, information gathering, investigation of complex claims, detailed record-keeping, clear communication, and collaboration with leadership.

Requires a P&C license or ability to obtain, strong MS Office skills, and knowledge of AMS360/ImageRight; bachelor’s in

Qualifications

• Valid P&C license or ability to obtain and maintain.
• Proficient in Microsoft Office Suite.
• Knowledge of AMS360 and ImageRight or ability to learn quickly.
• Strong analytical and detailed communication skills.
• Understanding of industry processes and regulations.
• Excellent communication with leadership, coworkers, insureds, and carriers.
• Ability to work independently and in a team.
• Well-organized with attention to detail.

Responsibilities

• Review and process incoming claims timely and accurately.
• Request and track qualifying information for submissions.
• Investigate and resolve complex claim issues.
• Maintain detailed claim records and correspondence.
• Communicate status and next steps with customers and carriers.
• Monitor large claims and keep insured informed from start to close.
• Notify SVP Operations of large concerns.
• Deliver excellent customer service addressing concerns and complaints.
• Analyze claims to help prevent fraud.
• Generate loss run reports for stakeholders and leadership.
• Perform other duties as assigned.

Skills

P&C license

MS Office

AMS360

ImageRight

Analytical skills

Communication

Independent worker

Interpersonal skills

Organizational skills

Team player

Education

Bachelor's in business or equivalent

Experience in insurance claims

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

About Sovereign Insurance Group Since 1959, Sovereign Insurance Group has been a leader in the nonprofit, commercial property and casualty marketplace. A growing company that has expanded from one location in southeastern PA to a multi-state organization, we are poised to continue our expansion. We believe in approaching our clients, our insurance companies, and our employees with humility and always considering the other party's interests above our own. This philosophy guides us in taking our talents, our time, and industry know-how to provide the best overall results we can for our clients.