Senior Claims Technical Specialist

Gainbridge; Zionsville (IN); Remote; USD 67,000 - 110,000; Full time

Job summary

An established industry player is seeking a Senior Claims Technical Specialist to enhance their claims management processes. This role involves overseeing Third Party Administrator relationships, supervising Claims Adjusters, and ensuring compliance with best practices in claims handling. You will play a crucial role in resolving complex claims and customer service issues for large accounts. This position offers a supportive work environment that values diversity and employee contributions, making it an exciting opportunity for professionals looking to make a significant impact in the insurance sector.

Benefits

Health insurance

Dental insurance

Vision insurance

Life insurance

Disability insurance

401K plan with matching contributions

Employee Assistance Program

Wellness initiatives

Qualifications

• 10+ years of experience in Workers’ Compensation and claims resolution.
• Strong analytical and communication skills are essential.

Responsibilities

• Manage TPA relationships and oversee Claims Adjusters.
• Resolve complex customer service issues and claim disputes.

Skills

Workers’ Compensation expertise

Analytical skills

Communication skills

MS Excel

General Liability knowledge

Adjuster’s license

Job description

Senior Claims Technical Specialist page is loaded

Senior Claims Technical Specialist

Apply remote type Remote locations Zionsville, Indiana Atlanta, Georgia Cincinnati, Ohio Nashville, Tennessee Philadelphia, Pennsylvania time type Full time posted on Posted 8 Days Ago job requisition id R25_0114

Group 1001 is a consumer-centric, technology-driven family of insurance companies on a mission to deliver outstanding value and operational performance by combining financial strength and stability with deep insurance expertise and a can-do culture. Group 1001’s culture emphasizes the importance of collaboration, communication, core business focus, risk management, and striving for outcomes. This goal extends to how we hire and onboard our most valuable assets – our employees.

Company Overview:

Clear Spring Property and Casualty Group (CSPCG) is comprised of four insurance carriers (Clear Spring Property and Casualty Company, Clear Spring Casualty Insurance Company, Clear Spring American Insurance Company, and Clear Spring National Insurance Company), each rated A- (Excellent) by A.M. Best. CSPCG assists companies in protecting themselves from today’s challenges through technology and innovation. CSPCG provides worker’s compensation, general liability, and other coverages through strong agency relationships.

Clear Spring Property and Casualty Group is a subsidiary of Delaware Life Insurance Company and its parent company, Group 1001, a collective that empowers companies to create positive growth. Everything Group 1001 does is designed to help individuals and communities thrive. Our insurance and annuities make financial products easy to understand and accessible to all. Our online investing platform gives individuals control over their savings and their futures. Our technology and innovation help companies succeed. And our strategic partnerships bring people together through education and sports. Because we all have the power to grow better. Clear Spring’s risk management solutions evolve with market needs, while traditional insurance companies struggle to keep up. Our data-driven approach and mastery of emerging technologies provide a deeper connection with customers by developing smarter, more adaptive ways to interact that address the needs of brokers and their policyholders.

We’re confident that you’ll love partnering with us.

The Senior Claims Technical Specialist will primarily be responsible for providing support and oversight to manage Third Party Administrator (TPA) relationships and Claims Adjusters. The specialist will work to resolve issues with Risk Managers in support of our client base of large accounts.

Main Accountabilities

• Review weekly and monthly loss runs to monitor claim development and reserve adequacy for multiple lines of insurance.
• Supervise and assist a team of experienced Claim Adjusters that work for our various TPA partners.
• Monitor the performance of multiple TPAs to ensure compliance with Carrier Claim Handling Instructions and Best Practices.
• Work closely with TPA adjusters and legal counsel to develop claim resolution strategy for more complicated claims involving multiple jurisdictions and multiple lines of insurance and provide reserve and settlement authority of up to $100,000 total incurred.
• Manage and resolve complex customer service issues and claim reserve disputes with Risk Managers of Large Accounts and our MGA partners.
• Assist with the timely Carrier reporting and updating of claim developments in accordance with applicable reinsurance treaties.

Qualifications

• 10+ years of Workers’ Compensation technical expertise, claim resolution skills and knowledge of insurance and claim principles.
• Excellent analytical and strategic skills required.
• Effective oral and written communication skills required.
• Strong MS Excel skills required.
• Knowledge of General Liability and Personal Injury experience is a plus.
• Adjuster’s license in at least one state or industry designation such as CPCU is a plus.

Our compensation reflects the cost of labor across several U.S. geographic markets. The base pay for this position ranges from $67,000 in the lowest market up to $110,000/year in our highest geographic market. Pay is based on a number of factors including market location and may vary depending on job-related knowledge, skills, and experience.

Benefits Highlights:

Employees who meet benefit eligibility guidelines and work 30 hours or more weekly, have the ability to enroll in Group 1001’s benefits package. Employees (and their families) are eligible to participate in the Company’s comprehensive health, dental, and vision insurance plan options. Employees are also eligible for Basic and Supplemental Life Insurance, Short and Long-Term Disability, and to enroll in the Company’s Employee Assistance Program and other wellness initiatives. Employees may also participate in the Company’s 401K plan, with matching contributions by the Company.

Group 1001, and its affiliated companies, is strongly committed to providing a supportive work environment where employee differences are valued. Diversity is an essential ingredient in making Group 1001 a welcoming place to work and is fundamental in building a high-performance team. Diversity embodies all the differences that make us unique individuals. All employees share the responsibility for maintaining a workplace culture of dignity, respect, understanding, and appreciation of individual and group differences.