AVP, Lead Claims Specialist

1 month ago

New York, United States QBE Insurance Full time
Primary Details
Time Type: Full time

Worker Type: Employee

The Opportunity

The job will oversee and manage assumed reinsurance excess of loss and proportional business emanating from QBE Re's casualty book of business. Ensure that all claims are being properly reported to QBE Re pursuant to the terms and conditions of the reinsurance contract(s). This includes evaluating reinsurance coverage, as well as the coverage being provided in an underlying policy, and if warranted, take the appropriate coverage position. Review claims for reserve adequacy (including ACR's). Validate and certify that all claim payment requests are being billed properly and in line with the reinsurance agreement. Complete either on site or remote reinsurance claim audit when necessary. Alert Underwriters and Actuary of any adverse trends/developments. Ensure compliance to QBE Re's internal guidelines and procedures.

Primary Responsibilities
  • Complete either on-site or remote reinsurance claim audits when necessary.
  • Deliver quality claims service to our internal (underwriters; actuaries; etc.) and external partners (Brokers and Cedent's).
  • Manage a portfolio of reinsurance claims (via our ProSume system), from cradle to grave, in accordance with QBE Re's Claim Guideline and Procedures to ensure a favorable outcome.
  • Where necessary, conduct investigations on all assigned claims in order to provide timely and accurate facts for evaluation of each assigned claim
  • Interpret the applicable insurance and reinsurance contract(s) and apply that to the exposures presented with each assigned reinsurance claim
  • Complete Large Loss Reports (LLR's) for upper management when required (+/- $500,000)
  • Resolve claims in a timely and fair manner and in accordance with all applicable laws, regulations and statutes
  • Collaborate with QBE's staff attorney's on coverage issues in order to formulate a strategy to achieve a favorable outcome
  • Review reserves on all assigned claim files and recommend changes (ACR's) where necessary to ensure claim and actuarial accuracy
  • Collaborate with other internal Centers of Expertise in a timely manner where indicated to facilitate the delivery of superior claims outcomes
  • Serve as an expert resource on complex claims or assigned claims requiring special handling
  • Take ownership for personal development and career planning, and development of required skills, tools, techniques, and technology to continually add value to the organization
  • Undertake claims resolutions activities in accordance with claims best practices and Department of Insurance (DOI) compliance to support quality claim results
  • Provide the highest level of customer care, responsiveness, and satisfaction when managing assigned claims to deliver superior claim outcomes
  • Direct, control, and manage relationships with vendors to deliver accurate, timely, and cost effective solutions
  • Manage budgeted resources by anticipating expenditures, accurately forecasting resource needs/costs and properly accounting for expenses to meet requirements and achieve fiscal responsibility
Required Education

Bachelor's Degree or equivalent combination of education and work experience

Required Experience

Minimum 7 years' experience in the insurance industry

Preferred Competencies/Skills
  • Generate original, innovative solutions to difficult or unusual situations
  • Identify and locate information and facts which are necessary and relevant for the purposes of evaluating a claim
  • Financial and business acumen and awareness of financial responsibility
  • Quickly change direction when working on multiple projects or issues
  • Guide team to properly document investigation findings and preserve evidence in accordance with internal and external laws and procedures
  • Use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems
  • Assume a methodical approach to a given situation and develop a systematic procedure as a response
  • Develop effective negotiation strategies and prepare a plan of action
  • Build and capitalize on beneficial internal and external relationships including competitors
  • Coach and encourage employees towards continuously improving performance and mentor team with feedback, on-the-job skill enhancement opportunities and career advice
  • Build and establish constructive and cooperative working relationships and open lines of communication
  • Utilize effective communication skills to influence and persuade decision makers
Preferred Knowledge
  • Working knowledge of a Reinsurance Contract.
  • Experience managing Casualty Lines claims
  • Working knowledge of current and possible future policies, practices, trends, technology and information affecting the business and organization; knows how the business works
  • Working knowledge of relevant claims legal and technical knowledge for all US jurisdictions
  • Working knowledge of insurance policy and contract language
  • Working knowledge of business and management principles involved in strategic planning, resource allocation, leadership technique and coordination of people and resources
About QBE

We can never really predict what's around the corner, but at QBE we're asking the right questions to enable a more resilient future by helping those around us build strength and embrace change to their advantage.

We're an international insurer that's building momentum towards realizing our vision of becoming the most consistent and innovative risk partner.

And our people will be at the center of our success. We're proud to work together, and encourage each other to enable resilience for our customers, our environment, our economies and our communities.

With more than 12,000 people working across 27 countries, we're big enough to make a real impact, but small enough to provide a friendly workplace, where people are down-to-earth, passionate, and kind.

We believe this is our moment: What if it was yours too?

Your career at QBE - let's make it happen

https://www.linkedin.com/company/qbe-north-america/

US Only - Travel Frequency
• NA

US Only - Physical Demands
• General office jobs: Work is generally performed in an office environment in which there is not substantial exposure to adverse environmental conditions. Must have the ability to remain in a stationary position for extended periods of time. Must be able to operate basic office equipment including telephone, headset and computer. Incumbent must be able to lift basic office equipment up to 20 lbs.

US Only - Disclaimer
• To successfully perform this job, the individual must be able to perform each essential job responsibility satisfactorily. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential job responsibilities.

Job Type
• Individual Contributor

Global Disclaimer
• The duties listed in this job description do not limit the assignment of work. They are not to be construed as a complete list of the duties normally to be performed in the position or those occasionally assigned outside an employee's normal duties. Our Group Code of Ethics and Conduct addresses the responsibilities we all have at QBE to our company, to each other and to our customers, suppliers, communities and governments. It provides clear guidance to help us to make good judgement calls.

Inclusion of Diversity

At QBE, we are deeply committed to fostering an inclusive workplace where each person is valued and respected for their authentic selves. If you require any assistance, such as alternative interview accommodations during the recruitment process, please do not hesitate to inform our Talent Acquisition team.

Compensation

Base pay offered will vary depending on, but not limited to education, experience, skills, geographic location and business needs

Annual Salary Range: $100,000 - $150,000

AL, AR, AZ, CO (Remote), DE, FL, GA, IA, ID, IL (Remote), IN, KS, KY, LA, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NV, OH, OK, OR, PA, SC, SD, TN, TX (Remote, Plano), UT, VA, VT, WI, WV and WY
* * * * *

Annual Salary Range: $110,000 - $165,000

CA (Remote, Fresno, Irvine and Woodland), Greenwood Village CO, CT, Chicago IL, MA, MD, NY (Remote), RI, Houston TX and WA
* * * * *

Annual Salary Range: $125,000 - $187,000

San Francisco CA, NJ and New York City NY

Benefit Highlights

You are more than your work - and QBE is more than a workplace, which is why QBE provides you with the benefits, support and flexibility to help you concentrate on living your best life personally and professionally. Employees scheduled over 30 hours a week will have access to comprehensive medical, dental, vision and wellbeing benefits that enable you to take care of your health.

We also offer a competitive 401(k) contribution and a paid-time off program. In addition, our paid-family and care-giver leaves are available to support our employees and their families. Regular full-time and part-time employees will also be eligible for QBE's annual discretionary bonus plan based on business and individual performance.

At QBE, we understand that exceptional employee benefits go beyond mere coverage and compensation. We recognize the importance of flexibility in the work environment to promote a healthy balance, and we are committed to facilitating personal and professional integration for our employees. That's why we offer the opportunity for hybrid work arrangements.

If this role necessitates a hybrid working model, candidates must be open to attending the office 8-12 days per month. This approach ensures a collaborative and supportive work environment where team members can come together to innovate and drive success.



How to Apply:

To submit your application, click "Apply" and follow the step by step process.

Equal Employment Opportunity:

QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.

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