Corporate Claims Consultant

Old Republic Commercial Risk; Town of De Witt (NY); In loco; USD 120.000 - 170.000; Tempo pieno

Descrizione del lavoro

Old Republic Commercial Risk in New York seeks a senior claims leader to provide technical direction to claims staff handling complex matters. You will oversee unbundled and bundled claims, ensuring reserves and settlements stay within authority limits and align with corporate standards.

Responsibilities include evaluating QA processes, leading policy development, training staff, and fostering compliance with regulatory and internal requirements.

Competenze

• 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.

Mansioni

• Provide technical oversight for unbundled claims assigned to TPA partners inclusive of reserve and settlement authority beyond TPA discretionary limits.
• Provide overflow support to bundled claims handled by PMAIC field claims including reserve and settlement authority beyond field authority.
• Directly handle an assigned pending of corporately established liability files.
• Support compliance activities relative to TPAs.
• Support Quality Assurance processes to assess quality of work and identify improvement opportunities.
• Develop, communicate and ensure adherence to corporate policies and procedures; lead project teams to resolve corporate claims issues.
• Assess staff training needs and conduct training to improve performance.
• Demonstrate commitment to Company’s Code of Business Conduct and Ethics and apply compliance policies, standards, and laws.

Conoscenze

Leadership

Coaching

Teamwork

Analytical thinking

Decision making

Negotiation

Customer service

Communication

Formazione

Bachelor’s degree or 5+ years in insurance

CPCU or AIC (desirable)

Strumenti

MS Office (Word, Excel, PowerPoint)

Descrizione del lavoro

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.