Program Claim Specialist (Remote USA)

CMFG Life Insurance Company; United States; Remoto; USD 93.000 - 140.000; Tempo pieno

Descrizione del lavoro

TruStage seeks a senior claims professional to oversee program TPA relationships and handle complex liability litigation. You will guide claim strategy, ensure timely processing, and collaborate with underwriting, actuarial, product, finance, and treasury to optimize program business. Travel ~10% is required.

A strong background in P&C claims and professional designations is preferred. The role emphasizes leadership in claim operations, QA reviews, and process improvements to meet corporate

Competenze

• Bachelor's Degree in Business Administration, Insurance, Finance, Economics, or related field strongly preferred.
• 7+ years of P&C Insurance claims experience.
• Adjuster license and continuing education as needed.
• Proven ability to clearly and effectively communicate information to internal/external clients remotely or in person.
• Experience in Property and Casualty lines including Property, General Liability, Auto Liability and Physical Damage Liability, and Professional Liability.
• Ability to travel ~10%.
• CPCU, AIC, ASLI, or other industry designations are highly desirable.

Mansioni

• Serve as the primary point of contact and relationship manager for program claims.
• Proactive litigation management on assigned claims including investigating, evaluating, and negotiating to resolution.
• Coordinate operational and leadership responsibilities to ensure consistent claim results, quality, and customer service.
• Develop protocols to aid in the establishment and maintenance of claim strategies and appropriate claim handling authority providing education and training as required.
• Collaborate with business partners vetting and onboarding new Programs and TPAs.
• Monitor and improve the communication of essential claim information to ensure that monthly data collection and information sharing practices support TruStage Corporate standards.
• Work in close collaboration with cross-functional teams including Underwriting, Actuarial, Product, Finance, and Treasury to analyze and structure existing and new Program Business.
• Conduct in-person or remote claim file reviews and audits on multiple TPA claim systems.
• Travel as required to participate with Program Managers, Brokers, Reinsurance Intermediaries, Claim TPAs, and other clients, including traveling to Industry association meetings and conferences.
• Identifies emerging claim trends as warranted.
• Monitor and document claim processes/guidelines for effectiveness and efficiency, identifying and implementing process improvements.
• Participate in Claim organization strategy initiatives and projects in collaboration with the Claim Operations team.
• Collaborate with Claim Operations leaders regarding the selection and ongoing management of TPAs and other outside vendors.

Conoscenze

P&C claims experience

Analytical skills

Communication skills

Industry designations (CPCU/AIC/ASLI)

Travel readiness

Formazione

Bachelor's degree in Business Administration/Insurance/Finance/Economics

Descrizione del lavoro

At TruStage, we're on a mission to make a brighter financial future accessible to everyone. We put people first, and work hand in hand with employees and customers to create a diverse and inclusive environment. Passionate about building insurance and financial services solutions, we push the boundaries of what's possible. We need you to help us shape what's next. You'll be encouraged to share your experiences, ideas and skills to help others take control of their financial future.

Join a team that has received numerous awards for being a top place to work: TruStage awards and recognition

Job Purpose

This position is responsible for oversight of assigned Program Third Party Administrators (TPA's) and handling new and existing litigation claims. Ensure timely and effective application of policies and processes. Accountable for team goals related to customer service and compliance with best practices. Provide claim file direction and assistance with complex claim issue resolution. Maintain effective communication with internal and external business partners. Participate in quality assurance reviews and work on special projects to best meet the needs of the department. Contribute to the development of functional/team strategy. The position will also handle complex professional and general liability litigated claims.

Job Responsibilities

• Serve as the primary point of contact and relationship manager for program claims.
• Proactive litigation management on assigned claims including investigating, evaluating, and negotiating to resolution.
• Coordinate operational and leadership responsibilities to ensure consistent claim results, quality, and customer service.
• Develop protocols to aid in the establishment and maintenance of claim strategies and appropriate claim handling authority providing education and training as required.
• Collaborate with business partners vetting and onboarding new Programs and TPA's.
• Monitor and improve the communication of essential claim information to ensure that monthly data collection and information sharing practices support TruStage Corporate standards.
• Work in close collaboration with cross-functional teams including Underwriting, Actuarial, Product, Finance, and Treasury to analyze and structure existing and new Program Business.
• Conduct in-person or remote claim file reviews and audits on multiple TPA claim systems.
• Travel as required to participate with Program Managers, Brokers, Reinsurance Intermediaries, Claim TPA's, and other clients, including traveling to Industry association meetings and conferences.
• Identifies emerging claim trends as warranted.
• Monitor and document claim processes/guidelines for effectiveness and efficiency, identifying and implementing process improvements.
• Participate in Claim organization strategy initiatives and projects in collaboration with the Claim Operations team.
• Collaborate with Claim Operations leaders regarding the selection and ongoing management of TPA's and other outside vendors.

Job Requirements

• Bachelor's Degree in Business Administration, Insurance, Finance, Economics, or related field of study is strongly preferred.
• 7+ years of P&C Insurance claims experience.
• Adjuster license and continuing education as needed.
• Proven ability to clearly and effectively communicate information to internal/external clients remotely or in person.
• Strong critical thinking and analytical skills.
• Demonstrated experience in progressively senior claim roles with strong technical skills.
• Experience in a range of Property and Casualty lines of business and products including Property, General Liability, Automobile Liability and Physical Damage Liability, and Professional Liability.
• Strong interpersonal and consultative skills.
• Creativity, flexibility, emotional intelligence, adaptability, and problem-solving skills.
• Ability to manage and develop existing and new industry relationships with Program Managers, Brokers, and Reinsurance partners.
• CPCU, AIC, ASLI, or other industry designations or certifications are highly desirable.
• Ability to travel ~10%.

#LI-Remote

Compensation may vary based on the job level, your geographic work location, position incentive plan and exemption status.

Base Salary Range:
$93,100.00 - $139,700.00

At TruStage, we believe a sou