Corporate Claims Consultant

Old Republic Commercial Risk; Tampa (FL); Sur place; USD 90 000 - 140 000; Plein temps

Résumé du poste

Old Republic Commercial Risk in Tampa seeks a senior claims leader to provide technical direction and oversee quality assurance on highly complex claims. You will drive compliance with standards, develop corporate policies, and lead initiatives to improve outcomes across the claims team.

The role requires a bachelor’s degree or 5+ years in insurance, strong leadership, and excellent communication skills. CPCU/AIC or equivalent designation is preferred.

Qualifications

• Bachelor's degree or 5+ years of equivalent work experience in an insurance related industry required.
• Extensive knowledge of insurance contracts and adjusting techniques. Familiarity with medical terminology.
• Demonstrated leadership, coaching, and teamwork skills.
• Advanced skills in applying sound judgment/analysis, decision making/problem solving, planning and organization and negotiation.
• Demonstrated customer service and collaboration skills.
• Excellent verbal and written communication skills.
• Computer literacy, including working knowledge of MS Office Product Suite, i.e. Word, Excel, PowerPoint.
• Previous supervisory experience, CPCU and AIC, or similar professional designation, desired.

Responsabilités

• Provide technical oversight for unbundled claims with reserve and settlement authority beyond TPA discretionary limits.
• Provide overflow support to bundled claims handled by PMAIC field claims with excess authority.
• Direct handle assigned pending corporately established liability files.
• Support compliance activities related to TPAs.
• Support Quality Assurance processes to assess quality and identify improvement opportunities.
• Lead projects to resolve corporate claims issues and communicate policies and procedures.
• Assess staff training needs and conduct training to improve performance.
• Apply Code of Business Conduct and Ethics and ensure compliance with relevant policies and laws.

Connaissances

Leadership

Customer service

Communication

Decision making

Problem solving

Formation

Bachelor's degree or 5+ years experience

Outils

MS Office

Description du poste

Provides the highest level of technical direction to the claims staff to ensure appropriate outcomes for claims of the most complex nature. Executes quality assurance programs to evaluate staff adherence to the claim handling standards. Develops and ensures compliance with corporate policies and procedures.

Responsibilities

• Provide technical oversight for unbundled claims assigned to TPA partners inclusive of reserve and settlement authority in excess of TPA discretionary authority limits.
• Provide overflow support to bundled claims handled by PMAIC field claims inclusive of reserve and settlement authority in excess of field authority
• Direct handle an assigned pending of corporately established liability files
• Provide support to various compliance related activities relative to TPA's
• Support Quality Assurance processes to assess quality of work product, identify improvement opportunities and foster discussions that are focused on solutions to enhance results.
• Develops, communicates and ensures compliance with corporate policies and procedures. Leads project teams focused on resolving corporate claims issues.
• Assesses staff training needs and conducts training focused on improving performance.
• Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.

Requirements

Qualifications

• Bachelor's' degree or 5 or more years of equivalent work experience in an insurance related industry required.
• Extensive knowledge of insurance contracts and adjusting techniques. Familiarity with medical terminology.
• Demonstrated leadership, coaching, and teamwork skills.
• Advanced skills in applying sound judgment/analysis, decision making/problem solving, planning and organization and negotiation.
• Demonstrated customer service and collaboration skills.
• Excellent verbal and written communication skills.
• Computer literacy, including working knowledge of MS Office Product Suite, i.e. Word, Excel, PowerPoint.
• Previous supervisory experience, Chartered Property Casualty Insurance (CPCU) and Associate in Claims (AIC), or similar professional designation, desired.