• Provide service, expertise, and guidance to insured and claimants with a planned approach for prompt, fair handling of claims on a proactive and troubleshooting basis. 
• Monitor claims to reduce the impact of the claim on the client’s insurance and financial results. 
• Service claims on behalf of clients in all lines of commercial insurance following agency workflow procedures to ensure prompt and fair handling. 
• Work with insurance carriers to obtain the best claim resolution. 
• Support loss control in identifying effective cost reduction programs to minimize claim costs (i.e. return to work programs).
• Coordinate and participate in claim review meetings.
• Take responsibility for traveling for client meetings.
• Set priorities and manage workflow to ensure efficient, timely, and accurate products.
• Proactively respond to daily client correspondence quickly and accurately.
• Enter activity and other relevant information into the company’s software system following company procedures 
• Collaborate with risk advisors to identify claim issues, potential solutions, strategies and services for clients.

Skills: Claims Handling Expertise, Client Service and Guidance, Negotiation and Resolution, Loss Control and Cost Reduction, Meeting Facilitation and Coordination, Workflow Management, Software Proficiency, Collaboration and Problem Solving

• Gathering information and reporting new claims
• Obtaining adjuster assignments and circulating information to all parties involved
• Set future tasks for deadlines and follow-ups
• Assist insureds with claim and policy questions
• Read and review ROR, denial, and coverage position letters
• Prepare and attend claim reviews
• Conference calls on a weekly or monthly basis
• Advocate on the client's behalf throughout the claims process
• Communicate with various Reinsurance Companies regarding the submission of claims under various reinsurance treaties
• Receive, verify and match claims benefit cheques to be mailed to claimants

Skills: Claim Handling, Coordination and Communication, Task Management, Customer Service, Legal Understanding, Claim Review Preparation, Meeting Facilitation, Advocacy and Negotiation

• Input claims data in the claims system to reflect developments about payments and case reserves
• Oversee developments about some of the claims portfolio
• Assess cost submissions (in various currencies) for completeness 
• Prepare and input claim payment documentation for processing and approval
• Assess notified claims for accuracy and completeness
• Input claims data into the claims system and set initial case reserves
• Prepare and issue acknowledgment letters and other administrative correspondence
• Run management reports and generally maintain claims files
• Assist Claims Counsel in other related projects or tasks

Skills: Claims Data Input and Management, Portfolio Oversight, Cost Assessment and Currency Management, Claim Payment Processing, Accuracy and Completeness Review, Initial Case Reserves Setting, Administrative Correspondence, Report Generation and File Maintenance

• General Administration in supporting the Claims Team
• Receiving and handling inquiries
• Tracking the notification of all claim forms
• Issuing of claim forms where necessary
• Dealing with tracking and distribution of incoming post
• Ensuring all outgoing posts for the department are dealt with within the appropriate timescales
• Verification and copying/return of medical and financial documentation
• Scanning/faxing documents where necessary
• Meet service level agreements and achieve productivity and quality standards
• Deal with customer complaints defined in company guidelines
• Meet privacy and compliance guidelines.

Skills: Administrative Support, Customer Service, Document Management, Mail Management, Data Handling, Document Processing, Compliance Adherence, Problem Solving

• Answer inbound claims-related calls from members, producers and others, and make callbacks
• Proficiently determine the needs of the caller and then provide accurate and timely resolution.
• Take ownership and responsibility for resolving customer concerns with every interaction
• Support the organization’s and the Claims Team’s key priorities
• Manages business needs through entry-level project and analysis work 
• Assigning a high priority to customer excellence, quality and meeting service level agreements
• Manage the claim notification process including updating various systems and maintaining the claims register, sending out claim requirements and regular ongoing follow-up for outstanding requirements
• Communicate verbal and written information to those with a need to know
• Ensuring information is clear, accurate and compliant with all legal, privacy, confidentiality and company standards
• Perform all required calculations and ensure all activities comply with reinsurance treaties and legal and internal standards
• Assist other team members to ensure that the team meets objectives

Skills: Customer Service Excellence, Problem Solving, Ownership and Accountability, Project Management, Attention to Detail, Communication Skills, Compliance and Legal Knowledge, Team Collaboration

• Day-to-day claims operations, including claims evaluation and customer service following agreed quality and production standards.
• Interpretation of product Terms and Conditions effectively communicating resolutions to customers.
• Ensures complete and sound claims settlements, reviews and investigations following company policies and procedures.
• Ensure internal and external customers receive prompt, efficient and courteous attention for all transactions
• Know, practice, and ensure that company policies and procedures and state and federal laws are followed at all times.
• Ensure that all area conditions do not threaten employee safety. 
• Respond to and follow proper procedures on employee accidents, injuries, and loss or damage to any property. 
• Practice and instruct all employees in proper loss prevention and reaction procedures. 
• Report all incidents properly and immediately.
• Support all relevant KAR and ADESA initiatives.

Skills: Claims Operations Management, Customer Service Excellence, Claims Settlement Expertise, Efficiency and Courtesy, Compliance and Legal Adherence, Safety Management, Loss Prevention and Reaction, Initiative Support

• Receive, review, triage and accurately open new client claims in the claim database
• Accurately enter claims and financial data in various client databases and reconcile them with the internal claims system
• Take responsibility for preparing financial and data reports
• Create client loss runs and liaise with clients to clarify and confirm needs
• Ensure policy declarations are accurate and interact with clients to obtain appropriate set-up documents
• Troubleshoot data conflicts directly with clients and examiners
• Ensure claims are opened promptly and in conformity with client data standards
• Researching and understanding the nuances of loss report details
• Processing incoming and outgoing mail (regular and courier), financial recording of recovery cheques received
• Answering telephones, and general services required to assist smooth operation of the office

Skills: Claims Management, Data Entry and Accuracy, Financial Reporting, Client Communication, Problem Solving, Compliance and Standards Adherence, Research Skills, Office Administration

• Working experience in Property and Casualty insurance
• Have a Property and Casualty Adjuster License
• Knowledge of data management systems and processes (i.e. Outlook, Claims Management Systems, Excel Spreadsheets, Internet, Word, PowerPoint, etc.)
• Strong interpersonal and communication skills and the ability to work effectively with people in a wide range of positions.
• Excellent oral and written communication, including presentation skills Ability to document work in progress
• Ability to read and interpret documents (i.e. accident forms, medical/legal documents, etc.)
• Knowledge of ERISA regulations, required offsets and deductions, disability duration, and medical management practices
• Bilingual skills in English and Spanish
• Able to work in a team environment, and work independently

Qualifications: BA in Business Administration with 6 years of Experience

• A professional and adaptable communication style - both written and verbal
• Efficient administrative skills
• Strong numeracy, literacy, and IT skills
• A proactive attitude, and an enthusiastic approach
• Proven ability to work independently and in a team environment
• Knowledge of technical systems (Mainframe and AROW) 
• Ability to multi-task and adapt to various situations
• Must have a proactive attitude.
• Strong focus on customer service and meeting the demands of internal and external clients

Qualifications: BA in Insurance and Risk Management with 2 years of Experience

• Previous Claims Experience in a similar role
• Strong analytical and problem-solving skills
• Strong written and verbal communication skills
• Ability to make decisions and use own initiative when applicable
• Strong commitment to client service and quality
• Desire to work in a Continuous Improvement environment
• Strong research and follow-up skills
• Proven ability to successfully cope in a fast-paced, demanding environment
• Knowledge of Microsoft Office Suite and Microsoft Outlook 
• Knowledge of the Life Insurance Industry

Qualifications: BA in Healthcare Administration with 3 years of Experience

• Relevant business working experience
• Previous experience in the insurance industry/medical field
• Ability to communicate (oral and written) in English.
• Intermediate knowledge of Microsoft Office applications
• Knowledge of the Internet and email
• Detail-oriented and committed to a high degree of accuracy
• Strong analytical and organizational skills with strengths in prioritization and efficiencies
• Ability to read and interpret a health insurance contract
• Able to manipulate data correctly in multiple programs and spreadsheets
• Excellent communication (oral and written), grammar and business letter-writing skills in English

Qualifications: BA in Finance with 5 years of Experience

• Prior experience working in a customer service or call center environment
• Exhibits a professional and customer-centric demeanor while handling phone calls
• Ability to be flexible with work assignments
• Ability to multi-task, and process claims while not on the phone
• Exceptional attention to detail
• Relative computer experience relating to data entry and databases
• Must be able to meet minimum productivity requirements while maintaining a high level of accuracy
• Maintain strong professional working relationships with colleagues at all levels
• A Team Builder - Acts as a role model within the department in all facets of assigned job duties, while effectively providing feedback to team members and earning respect as a leader

Qualifications: BA in Legal Studies with 6 years of Experience

• Strong Excel skills, with strong attention to detail and a sense of urgency
• Excellent communication skills both written and oral
• Active Listening – give full attention to the words and body language of others
• Take time to understand the points being made and ask questions as appropriate
• Critical Thinking – using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
• Time Management – ability to prioritize workload and manage one’s own time
• Integrity - Acts ethically, maintaining a commitment to honesty and truth in all facets of behavior that builds the trust of others
• Work Ethic - Delivers accurate, timely and consistent results while understanding the need to balance short-term sacrifice for long-term gain
• Team Player - Supports the overall efforts of the team to accomplish departmental and Company goals and objectives

Qualifications: BA in Legal Studies with 7 years of Experience

• Minimum 5 GCSE Grades A-C including Maths and English
• Administration working experience preferably with claims handling
• An understanding of the Financial Industry would be advantageous
• Excellent organization skills with a professional telephone manner
• High level of literacy (letter and email writing is a must)
• A high degree of professionalism and discretion
• Excellent time-management skills with the ability to use your initiative
• Be friendly, approachable and reliable
• Exceptional attention to detail
• Proficient user of Microsoft Packages

Qualifications: BA in Legal Studies with 5 years of Experience