Claims Specialist I, II, Sr. - Little Rock AR
VetJobs · Little Rock, AR · 1 wk ago
FinanceFull-time
This position is open to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers.
About the role
Investigates, evaluates, and resolves Liability claims in assigned geographical jurisdictions while interacting daily with internal and external stakeholders to thoroughly and fairly resolve claims. This role will be filled as Customer Service Specialist I, II, or Sr. depending on experience level.
Responsibilities
- Handles claims in assigned territories from start to finish, including thorough liability investigations and resolutions based on sound claims adjusting best practices and company guidelines.
- Oversees the activities of contracted vendors when utilized.
- Interacts with field employees and customer service functions, answering questions, explaining liability and other technical issues, while informing Claims hierarchy of all claim-related circumstances (e.g., customer complaints, regulatory/executive complaints) requiring Management intervention/response.
- Ensures completion of thorough internal claim-status communications to management/leadership and other departments as appropriate.
- Provides thorough claim-status communications when appropriate to Legal, Risk Management, excess insurance broker/carriers, including timely issuance of reports.
- Follows protocols in establishing reserves/receivables and securing settlement authority per guidelines.
- Ensures all claims are properly documented and assertively handled.
- Ensures all claims are properly reserved for anticipated liabilities or recoveries, reviewing reserve adequacy at least once per month, and properly requesting authority to adjust large reserves.
- Ensures that all claims are properly coded in the claims database with respect to workgroup, cause of incident, charging of payments/recoveries, etc.
- Ensures thorough running notes and formal reporting is maintained in all claim files per requirements.
- Identifies opportunities for process improvements and spend/cost reductions, often participating on related teams.
- Participates in Safety training/reporting programs, storm response teams, and volunteerism.
Requirements
- Bachelor’s degree, generally in Liberal Arts, Business, Insurance, or Health Administration. Master’s degree a plus.
- Customer Service Spec I: 3-5 years of liability claims adjusting experience with property & casualty insurer, third-party administrator, or self-insured employer group.
- Customer Service Spec II: 5+ years of liability claims adjusting experience with property & casualty insurer, third-party administrator, or self-insured employer group.
- Customer Service Spec Sr: 10+ years of liability and/or subrogation claims adjusting experience with property & casualty insurer, third-party administrator, or self-insured employer group.
- Licensed Claims Adjuster (may be secured within the first year of employment). Desired: Industry claims designation (SCLA, CWCP, AIC, etc.).
Skills
- Commitment to Safety.
- Ability to explain the processes of investigating, evaluating, negotiating, resolving, documenting, and reporting-on complex claims.
- Understanding of elements of compensability, legal liability, fact-finding/discovery, and methods for claim adjudication.
- Ability to communicate with all levels throughout an organization, resolve conflict, accept push-back and criticism, understand “economic” decision-making, prioritize work, and operate standard computer applications.
- Acts as a resource for colleagues with less experience; may lead projects with manageable risks and resource requirements.
- Solves complex problems; takes a new perspective on existing solutions; exercises judgment based on the analysis of multiple sources of information.
- Impacts a range of customers, operational, project, or service activities within own team and other related teams; works within broad guidelines and policies.
- Ability to explain difficult or sensitive information; works to build consensus.
- Ability to prioritize and organize work.
- Ability to work independently in a fast-paced environment with diverse internal/external stakeholders.
- Proficiency in computer applications, such as Word, Excel, PowerPoint, and claims database.
Location
Arkansas: Little Rock | Louisiana: Reserve | Texas: Beaumont
Travel Percentage: Up to 25%