Claims Account Administrator

Responsibilities

• Performs other responsibilities and duties as needed.
• Information Management Responsible for collecting client’s claims data from various insurance carriers or TPA RMIS Systems including loss runs.
• Enter data into claims management systems and audit for accuracy, completeness, and conformity to established procedures.
• Enters claim and coverage information into claim management systems.
• Assist with development of claims management systems for tracking/monitoring, trending and reporting of claims statistics.
• Assist with tracking of trending, unique, or significant claims.
• Interact and support the account team with claim summary information as well as claim data.
• Internal and External Communication Fields all questions and acts on requests concerning claim progress; time is of the essence in responding to questions and requests.
• Receives and responds to routine internal/external client’s inquiries, maintains documentation of communications, existing issues, and issue resolutions, referring complex inquiries to more senior staff.
• Is proactive in handling daily communications paying special attention to items requiring immediate attention and ensuring they are addressed by claims team.
• Receives claim information from internal/external client or and verifies relevant policies for reporting to carriers and tracking in appropriate claim filing systems.
• Reports claim information accurately and promptly to the appropriate insurance carrier on behalf of the internal/external client; communicates claim information to insurance carrier and internal teams.
• Maintains communication with internal/external client and insurance carrier; prepares status reports on critical claims for client.
• Prepares written correspondence and makes telephone calls to claims adjusters as requested by senior staff.
• Helps produce communications such as newsletters, bulletins, presentations as requested by senior staff.
• Meets with Producer and Commercial Insurance Department associates concerning claims progress.
• Claims Process Quality Assurance Maintains and keeps records of clients.
• Assists in the upkeep of carrier adjuster information.
• Interact and support account team by scheduling and tracking client claims reviews.
• Takes notes at claims reviews and updates tracking systems as needed.
• Pulls loss runs, prepares agenda and other material for claim reviews.
• Protects the confidentiality of information learned by performing the duties of the position.
• Makes positive contribution to customer satisfaction and constantly strives to improve service to the customer.
• Industry Knowledge Acquires an understanding of insurance brokerage business and insurance coverages.
• Researches industry trends, government regulations and relevant statute and caselaw impacting external clients.

Qualifications

• Bachelor’s Degree in Business Administration or related field and/or years of experience equivalent