A&H Claims Specialist

SiriusPointNew York City, NY
Hybrid

About The Position

SiriusPoint is a specialty underwriter providing solutions to clients and brokers around the world. Bermuda-headquartered with offices in New York, London, Stockholm and other locations, we are listed on the New York Stock Exchange (SPNT). We have licenses to write Property & Casualty and Accident & Health insurance and reinsurance globally. Our offering and distribution capabilities are strengthened by a portfolio of strategic partnerships with Managing General Agents and program managers. With over $3.0 billion total capital, SiriusPoint’s operating companies have a financial strength rating of A from Fitch, A- from AM Best and S&P, and A3 from Moody’s. Join Our Team You will be our US A&H Claims Specialist, reporting into the A&H Claims Manager. In this capacity, you will handle claims emanating from the A&H Direct and Reinsurance books, including core MGA’s and developing claim strategies to drive the best possible results. The Claims Specialist will interact frequently with brokers and clients, evaluate claim notices, and approve authorizations and financial transactions on behalf of SiriusPoint.

Requirements

  • Bachelor’s degree (B.A. or B.S.) from a four-year college or University
  • Minimum of 10 years related A&H Direct and Reinsurance claims handling experience with an insurance carrier, MGA, MGU, TPA or equivalent combination.
  • Superior service orientated, strong organization skills and the ability to effectively communicate with brokers, clients and vendors.
  • Excellent verbal and writing skills.
  • Ability to identify, analyze, and solve problems as they relate to claims handling.

Responsibilities

  • Responsible for the claims handling, oversight and administration of Direct and Reinsurance A&H Claims, including compliance of standards and procedures as established by the Policies, Program Management Agreements, Claims Handling Guidelines and Reinsurance Contracts
  • Able to review and analyze monthly bordereaux, adverse trends and exposures to the A&H Claims Manager and make recommendations to management
  • Assure all claims are properly documented, reserved and processed timely, according to Best Claim Practices
  • Approve cash calls, payments and reserves on claims that are within your authority but in excess of the client’s authority and/or retention, established by SiriusPoint.
  • The ability to travel and audit approximately one week per month and complete audit reports of various clients in conjunction with the A&H Claims Manager.
  • Support finance with all claims related statutory data collection.
  • Assist with the due diligence of prospective programs and third-party administrators to support the evaluation of their ability to administer our policies.
  • Verify the exhaustion of Annual Aggregate Deductibles.
  • Advise the US Head of A&H and Life Claims along with the Global Head of Claims on all disputes, arbitrations, litigations and consumer complaints.
  • Interact with Senior Management on various projects and corporate goals.
  • Support management in the response, negotiation and settlement of various complaints or legal actions as needed.
  • Perform other duties as assigned or as may be necessary.

Benefits

  • Medical
  • Dental
  • Vision
  • FSA Medical and Dependent care
  • Health Savings Account (HSA)
  • EAP
  • Basic Life and AD&D (company paid)
  • Basic Long-Term Disability (employer) paid-Taxable income
  • Employee paid Long Term Disability(voluntary)
  • Company Medical Leave, Parental leave- 8 weeks full pay after 6 months of service
  • Voluntary benefits: short term disability, Critical illness, Hospital Indemnity, Accident
  • Travel assistance programs
  • Company paid 401(k) 6 % safe harbor match, fully vested after two years, pre- and post-tax contributions allowed
  • Gym reimbursement
  • Legal plan
  • Pet Insurance
  • Tuition reimbursement
  • Generous PTO
  • Flexible work arrangement
  • Fully stacked pantry on-site
  • Team outings
  • ERG Groups
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