Lead Claims Specialist - Reinsurance

QBE North America; Minnesota; Remote; USD 101,000 - 151,000; Full time

Job summary

Join a leading company as a Lead Claims Specialist - Reinsurance, where you will manage complex claims and collaborate with internal teams. This full-time role offers a competitive salary range and various benefits, including hybrid work options and professional development opportunities.

Benefits

Hybrid work

Paid family leave

401(k)

Tuition reimbursement

Community engagement

Qualifications

• 5+ years experience preferred in managing reinsurance A&H or medical stoploss claims.
• Proficiency with Microsoft Office, especially Excel.
• Knowledge of TPA networks and medical billing.

Responsibilities

• Administer reinsurance coverage for complex claims.
• Communicate effectively with brokers and clients.
• Review claims and adjudicate losses.

Skills

Communication

Data Analysis

Claims Management

Education

Degree or equivalent experience

Tools

Microsoft Office

Job description

Join to apply for the Lead Claims Specialist - Reinsurance role at QBE North America.

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Primary Details

Time Type: Full time

Worker Type: Employee

The Opportunity

This role supports the Claims Manager in managing assumed reinsurance excess of loss and proportional business for QBE Reinsurance's A&H portfolio, ensuring proper reporting and documentation of all claims in accordance with reinsurance contract terms. The Lead Claims Specialist will perform complex claims reviews, conduct claims data analyses, assess health and billing records, and validate eligible benefits and losses under plan contracts. The role also involves ensuring timely and accurate reserves, adjudicating claim payments within authority, and collaborating with various internal teams and external clients.

Location

Minnesota - remote

Salary Range

The starting salary is between $101,000 and $151,000. Compensation will be based on role complexity, location, and candidate experience.

Your Responsibilities

• Administer reinsurance coverage for complex claims, including loss investigations and data analysis.
• Communicate effectively with brokers and clients to gather records and data.
• Provide claim support and project management in collaboration with Underwriting and Actuary teams.
• Participate in meetings with internal and external stakeholders.
• Review claims, reconcile payments, and adjudicate losses.
• Support Claims strategy implementation and process development.
• Forecast Claims activity and manage large reserve reports.
• Triage complex cases for clinical review and external audits.
• Ensure compliance with statutory and corporate standards.
• Manage own caseload efficiently and resolve customer issues promptly.
• Develop client relationships and participate in ongoing education.

Work Experience

Moderate relevant experience required; 5+ years preferred in adjudicating and managing reinsurance A&H or medical stoploss claims, data analysis, client interaction, and trend analysis.

Qualifications

• Degree or equivalent experience.
• Proficiency with Microsoft Office, especially Excel, Outlook, Teams.
• Knowledge of TPA networks, medical billing, health benefits, and coordination of benefits.
• Strong communication skills.

Benefits & Compensation

Includes hybrid work, paid family leave, 401(k), well-being programs, tuition reimbursement, and community engagement. The salary range is as specified, with bonuses based on performance.

Why QBE?

We aim to create a resilient future, supporting our communities and employees. Join us to make a meaningful impact and grow your career in a dynamic environment.

Additional Information

QBE is committed to diversity and providing accommodations. We offer equal employment opportunities regardless of race, gender, or other protected statuses.