Auditor Delegated Authority, Claims

Trisura Guarantee Insurance Company•Oklahoma City, OK

About The Position

At Trisura, we expect more because we believe it can be done better. Trisura brings innovative solutions and expertise through a select network of both national and regional brokerage firms. The company, founded in 2006, and operating across North America with offices throughout Canada and the United States, we are uniquely positioned to satisfy all varieties of risk in Contract, Commercial and Developer Surety, Directors' and Officers' Liability, Fidelity, Professional Liability and Media Liability. We are currently seeking a qualified individual for the following opportunity AUDITOR DELEGATED AUTHORITY, CLAIMS This position plays a key role in maintaining the fronting insurer’s brand and interests while fostering strong working relationships with claim administrators and key stakeholders. This is a hands-on auditor role, within a fronting insurer framework, responsible for delivering oversight of entities with delegated claims handling authority. The primary responsibility of this role is performing audits of claims administrators and delivering important feedback from data and analysis of information as captured during audit and reviews. Duties also include audit preparation and drafting of audit reports to include summary of findings and providing recommendations based upon same. A deep understanding of insurance regulations, good faith claims handling practices, coverage and liability analysis, and the roles and responsibilities of Third-Party Administrators (TPAs) within a program business model is required. As an integral member of the team, you will bring Dynamic, motivated, and self-confident disposition capable of delivering expected results without the need for supervision Tenacious, resilient, and resourceful persona with the ability to thrive in a fast-paced environment Dedication to exceptional customer service and good commercial awareness Proven ability to work effectively within a team environment Strong analytical and problem-solving skills, plus a pragmatic, process-oriented work style with a passion to learn and strive for continued professional growth Strong interpersonal and relationship-building skills, especially effective in delivering constructive feedback and in championing support Integrity and personal credibility along with effective and articulate communication skills

Requirements

Required minimum of five (5) years' experience in claims management/supervision with a focus on complex exposures in all lines; claims handling best practices auditing experience considered a plus
Minimum of ten (10) years’ experience in direct performance of claims handling specific to commercial and residential property, commercial and personal auto (interstate and intrastate trucking experience considered a plus), and commercial general liability (NY Labor Law, liquor liability, and hospitality experience considered a plus)
Background in oversight and control, knowledge of regulatory environment, legal contracts, and data analytics considered a plus
Bachelor’s degree in risk management, business administration, finance, or related field preferred; Insurance industry recognized accreditation considered a plus.
Current and in good standing Resident State Adjusters License with P&C lines of authority
Software Proficiency: Familiarity with claims management systems (e.g. Duckcreek, Guidewire, FileHander, Virtual Claims Adjuster) considered a plus
Competence in the Microsoft suite of products (specifically, Word and Excel)

Responsibilities

Audit Performance: Executes detailed and outcome-based audits that include, but also go beyond process compliance, to access the accuracy and adequacy of reserves, the accuracy of coverage determinations, the effectiveness of litigation strategies, and the alignment of claim outcomes with program expectations.
Vendor Engagement/Collaboration: Maintains strong relationships with claim administrators to promote a cohesive and effective engagement.
Planning & Preparation: Performs analysis of claims data (i.e., dashboard, claims bordereaux, litigation log, etc.) and claims metrics (i.e., complaints, internal/external feedback, etc.) to support effective planning and focused audit testing.
Reporting Results: Delivers actionable insights from audit findings in a formal report format, focused on driving continuous improvement in claims outcomes. Coordinates with peers and management for follow-up on any adverse findings to ensure that they are appropriately addressed through to proper resolution/satisfaction. Likewise, identifies risks with TPA’s and appropriately escalates along with recommendations for corrective measures and/or a compensating ongoing monitoring framework.
Process Improvement: Supports the ongoing development of the claims audit and performance monitoring value proposition by contributing to the enhancement of procedures, templates, and supporting tools. Likewise, identifies opportunities for process optimization within the Delegated Authority Claims audit framework to enhance efficiency and effectiveness.
Travel as needed and/or warranted
Perform other duties as required or assigned which are reasonably within the scope of the duties in this job description

Benefits

Trisura offers competitive compensation along with a comprehensive benefit package that includes medical, dental, and vision insurance, as well as 401(k) with company match and Employee Stock Purchase Plan.

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