Senior Claim Specialist - Prime Specialty

Full-time - Mid Level

NY

About the position

The position involves analyzing and processing claims by gathering information and drawing conclusions. The individual will act as a liaison between the insured and the insurance carrier to report, track, and manage the claims process. Additionally, the role provides leadership to all employees within the claims department.

Responsibilities

• Supervise a multi-person team ensuring all pertinent information is communicated.
• Evaluate claims, reporting forms and cancellations and initiate necessary corrections to ensure accuracy of dates, coverage, signature, commission, premium, attachments, etc.
• Authenticate all relevant activity on assigned files and make recommendations for additional activity as appropriate.
• Determine where new loss claims should be reported.
• Manage all claim documentation.
• Use discretion to submit the necessary information and/or correspondence to the Agent or Insurer to process claims appropriately.
• Analyze claim coverage with insurance carriers to ensure claims are paid accurately.
• Assess eligibility status of denied claims.
• Anticipate and meet all customer needs (both internal and external).
• Maintain claims and suspense system ensuring follow-up for receipt of policies, endorsements, inspections reports, correspondence, claims, etc. from outside sources.
• Process all departmental claims in a timely manner according to company policy.
• Facilitate the training of new employees in the department.
• Provide supervision to Claims Assistants.
• Perform other duties as assigned.

Requirements

• Bachelor's degree with a concentration in business or equivalent work experience.
• Three years of Claims handling experience and commercial and multi-line knowledge.
• Ability to critically review a claim file for relevant information, accurately access the information and make necessary recommendations.
• Ability to make independent decisions following CRC guidelines with minimal or no supervision.
• Good organizational, time management, and detail skills.
• Extensive knowledge of insurance and CRC processes.
• Ability to maintain a high level of tact and professionalism.
• Good leadership skills to influence all departmental employees in a positive manner.
• Possess strong interpersonal skills.
• Strong verbal and written communication skills.
• Strong computer and office skills.
• Ability to work extended hours when necessary.

Nice-to-haves

• Adjusting experience.

Benefits

• Medical, dental, vision, life insurance, disability, accidental death and dismemberment.
• Tax-preferred savings accounts.
• 401k plan.
• No less than 10 days of vacation during the first year of employment.
• 10 sick days.
• Paid holidays.
• Defined benefit pension plan, restricted stock units, and/or a deferred compensation plan may be available.