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Sr. Claims Consultant

Company: INSURICA
Location: Oklahoma City
Posted on: November 19, 2021

Job Description:

We have a business with purpose and are looking for passionate, innovative people like you to join our team! INSURICA has built a rewarding environment for Colleagues and continues to uphold our solid customer pledge by "Specializing in You".
INSURICA has over 600 employees across 3 time zones, 6 states, and 30+ locations nationwide. We are among the 50 largest insurance brokers in the US and are currently the 23rd largest privately held independent agency in the country.
We take pride in our welcoming and diverse culture, internal growth opportunity, and robust compensation and benefit package. INSURICA provides our Colleagues with cutting edge resources, tools, and support so that we can be the best at what we do.
SUMMARY:Accountable for providing claim advocacy and claim oversight services for Tier 1, 2, & 3 clients for property and casualty and worker's compensation losses. These services include assuring complete and sound claim settlements, legal reviews and investigation, providing clients and/or carrier adjusters with leadership, direction, and problem resolution; and also reviewing and monitoring files to ensure adjusters are achieving desired quality and service levels and functions. Consultant is also responsible for maintaining current INSURICA Third Party Claims Administration functions for all self-insured clients claim needs. The Consultant is to provide claim advocacy and claim oversight services while developing and maintaining working relationships with team members and Production Personnel by consistently meeting the service needs of their customers and functioning as an integral member of these client's risk management services team working to maintain the quality and service standards of the agency.
ESSENTIAL FUNCTIONS:

  • Work with Claims Manager to develop performance and service standards. Assist in the preparation, implementation, and monitoring of the Risk Management Services department's claims management plans and client service responsibilities. Provide management reports as required by senior management to monitor performance
  • Report new losses (all lines except work comp) to carriers as needed. Update EPIC with new & ongoing claims information as needed
  • Respond to phone calls to handle difficult customers or claims situations with adjusters where needed
  • Investigate and handle assigned TPA Claims Administration cases, contact insureds and claimants within 24 hours of Notice of Loss. Establish and monitor reserves, conduct investigations and approve payments on a timely basis. Identify and resolve coverage disputes. Prepare and write estimates on damaged property. Obtain medical, wage and damage verification information and confirm. Evaluate and negotiate claims to settlement.
  • Answer inquiries and questions from insureds and claimants
  • Order Loss Runs and Prepare Quarterly, Semi-annual or Annual Loss Summaries
  • Create Special Claims Service Plans for VIP customers
  • Review all loss details for clarification of expenses versus indemnity on loss runs or closing notices; analyze claims for financial impact to client and company
  • Follow up for subrogation depending on type of claim
  • Review of time lapsed from date of loss to date reported and indicate lapse times to producer and customer
  • Rectify with carriers the status of all open claims
  • For all suits and large reserves, investigation of public court documents including driver criminal records
  • Comparison of prior year loss runs to current year loss runs (reserve analysis for Work Comp loss runs) to determine if reserves are higher/lower and referring to type of injury
  • Review and analysis of new Work Comp laws applicable to OK
  • Engages in field inspections for claims resolutions
  • Periodic meetings with producers and carrier claims representatives to solve issues or potential concerns regarding current customers acting as liaison between client and carrier
  • Accompany Team members on prospect calls when necessary
  • Seeks assistance from Loss Control & Risk Management Services to solve high-level claims issues
  • Assist Producers with those Tier level customers enrolled in the INSURICA Work Comp Experience including but not limited to ordering NCCI Worksheets, preparing Mod-Master reports
  • Advise producers/account managers of large claims settlements/reserves per established guidelines. Inform producers on status of large claims
  • Maintain and distribute Agency Claims Log, Large Loss Reports and Litigated Claims Reports.
  • Maintain working knowledge of all company change procedures
  • Review all activities relating to the public, customers and companies to avoid issues involving potential errors and omissions
  • Perform other duties as requested
  • Display a positive attitude and motivate employees by promoting a team environment.
  • Participate in seminars and other training to maintain required licenses and for knowledge and skill development
  • Display a positive attitude and motivate employees by promoting a team environment.
  • Participate in seminars and other training to maintain required licenses and for knowledge and skill development. ADDITIONAL RESPONSIBILITIES:
    • Adherence to company policies and procedures
    • Ability to perform job responsibilities through acceptable attendance
      KNOWLEDGE, SKILLS AND ABILITIES:
      • Thorough knowledge of commercial coverages
      • Self-starter, analytical and empathetic
      • -- Excellent communications skills, both verbal and written
      • Demonstrated computer skills in MS Office including Word and Excel and be able to effectively utilize agency management systems and internet claims systems provided by various insurance companies
      • Team player and willing to find accommodating solutions for our customers, companies and Agency
        QUALIFICATIONS:
        • Adjuster's or Property & Casualty license
        • High School diploma or equivalent. College education and AIC, CPCU, and CIC designations desirable
        • Minimum 10 years' experience handling workers compensation and casualty claims required
        • 5-10 years of experience handling liability claims on coverage including auto and/or general liability
        • Multi-line experience highly preferred
          WORKING CONDITIONS AND REASONABLE ACCOMMODATIONS:
          • Fast-paced multiple tasking, high disruption and ever-changing environment
          • Ability to perform 80% sedentary work exerting up to 10 pounds of force occasionally and negligible force frequently
          • All requirements may be modified to reasonably accommodate physically or mentally challenged employees MENTAL, PHYSICAL, AND ENVIRONMENTAL DEMANDS:
            • May require prolonged sitting
            • Requires operation of a computer workstation, including keyboard and video display terminal
            • Requires verbal and written communication
            • Mental or emotional fatigue can be caused by travel requirements, continuous repetition, concentrated attention for prolonged periods of time, or lack of control over work pace or priorities
            • Other demands may include: reading, watching, studying, observing; inspecting, proof reading, manual manipulation; operating office equipment, monitoring computer terminals, technical trouble shooting

Keywords: INSURICA, Oklahoma City , Sr. Claims Consultant, Professions , Oklahoma City, Oklahoma

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