Summary: Responsible for the overall function of the Claims units for the Agency.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
Serves as a client advocate in dealing with coverage issues and managing the dispute process. Verifies proper account set up for clients with carriers to ensure proper service coverage. Manages and coordinates large and complex claims and key client claims.
Coordinates and attends claims reviews with clients. Resolves customer claim issues in coordination with Account Executives and Producers in order to reduce Errors and Omissions (E&O) exposures. Ensures that Claims personnel complete activities in a timely manner, including following up with the insured to verify the claims process is managed appropriately, transmitting legal documents received to insurance carriers promptly, and identifying any areas here additional attention is needed.
Works with insurance carriers to resolve claim determinations unfavorable to insured. Investigates customer claim issues in coordination with Account Executives and Producers in order to reduce E&O exposure. Serves as liaison between claims staff and Account Executives and Producers. Attend claims reviews with Producers and Account Executives. Identifies any unusual claim related issues and potential impact.
Attends customer and prospective client meetings with Producers to present Agency programs and services. Coordinates and attends claims reviews as requested. Works closely with Producer during customer and prospective client visits to present Agency programs and offerings. Assists with the sales and renewal processes.
Coordinates account management and serves as primary contact as appropriate.
Reviews potential E&O situations to minimize exposure.
Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience
Bachelors Degree required
Law degree or legal training preferred and may be substituted for experience requirement. Minimum of 4 years profession experience required.
Ability to read and interpret documents such as insurance policies, safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
To perform this job successfully, an individual should have knowledge of Agency Management system; Database software; Internet software; Spreadsheet software and Word Processing software.
Other Skills and Abilities
Ability to use telephone, fax machine, personal computer, printer, calculator, copy machine, scanner, and shredder.
Must frequently work with the public, customers, and co-workers. Must regularly work with insurance vendors.
Certifications or licenses
Valid Adjuster license where required; Property and Casualty Agent license recommended.