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Insurance Claims Specialist
2 months ago
PRIMARY RESPONSIBILITIES
- Handles all incoming inquiries related to commercial insurance claims.
- Collects all necessary details regarding the claim from the producer and/or client.
- Maintains neutrality regarding coverage decisions for claims.
- Identifies relevant coverage and policy details related to the claim and completes the necessary ACORD documentation.
- Processes daily correspondence and phone communications related to ongoing claims, updating the Account Management System (AMS) accordingly.
- Acts as an advocate for clients to ensure proper claims management, including reserving and settlement processes.
- Investigates risk management services provided by carriers and other vendors, assessing potential benefits for clients; assists in setting safety objectives and metrics.
- Focuses on enhancing the claims process within the company to sustain a competitive advantage.
- Facilitates communication between clients and carriers, keeping producers and account managers informed.
- Serves as a claims authority, offering guidance and support for all inquiries.
- Handles administrative tasks such as photocopying, faxing, photographing, scanning, and emailing as necessary.
- Completes additional projects, responsibilities, and tasks as assigned.
ESSENTIAL QUALIFICATIONS
- High School Diploma or equivalent.
- Minimum of 3 years of proven experience in managing Workers' Compensation Claims.
- Exceptional interpersonal and communication skills to foster effective relationships with clients, colleagues, carriers, claim adjusters, and legal representatives.
- Comprehensive understanding of insurance markets, products, services, ratings, and underwriting processes.
- Strong analytical and numerical abilities.
- Intermediate proficiency in Microsoft Office, particularly Excel, Word, and Outlook.
- Ability to maintain a high level of accuracy and attention to detail.
- Excellent verbal and written communication skills.
- Outstanding customer service abilities are essential.
- Demonstrates a strong work ethic, positive attitude, and a proactive approach to responsibilities.
- Detail-oriented with the capacity to manage multiple tasks simultaneously.
- Strong organizational skills to handle substantial workloads.
- Familiarity with HIPAA regulations and a commitment to confidentiality.
- Ability to exercise initiative, sound judgment, and resourcefulness.
- Capable of working independently as well as collaboratively within a team.
- Proactive, dedicated, and achievement-oriented with a high level of enthusiasm.
- Skilled in developing long-term relationships that evolve over time, always prepared to act as a consultant and resource for clients.
- Values collaboration in a work environment.
CERTIFICATIONS/LICENSES
- Must possess and maintain a Property & Casualty License from the state of domicile.
- Certification in Workers' Compensation is required.
Note: The above description is not exhaustive of the full position responsibilities.
Relation Insurance Inc. is committed to providing equal employment opportunities to all employees and applicants, prohibiting discrimination and harassment of any kind based on race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This commitment applies to all employment terms and conditions, including recruitment, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
The salary range for this position considers various factors in compensation decisions, including skill sets, experience, training, licensure, certifications, and organizational needs. The disclosed range is an estimate and may not reflect geographic differentials associated with the position's location.
Participation in a discretionary annual incentive program may be available, subject to program rules, with awards based on individual and organizational performance.
