Captive Claims Advocate

Higginbotham•St. George, LA

1d•Onsite

About The Position

The Captive Claims Advocate is responsible for oversight and management of claims, including coordination of receiving new property and casualty first reports of claims via phone, email, fax, or mail from insureds. This role involves reporting claims to the appropriate carrier and following up to ensure timely and complete resolution. The position facilitates communication, documentation, and understanding between insureds, adjusters, and other involved parties to proactively move claims toward resolution. Additionally, the role assists with educating agency employees and clients on the claims process, works with various individuals including agency, clients, carriers, claims administrators, and captive personnel, and becomes proficient in state regulations applicable to workers' compensation benefits and mitigation programs offered by captive programs, educating both insureds and producers.

Requirements

High School Diploma is required
Experience handling worker’s compensation claims required
3+ years of experience in Property & Casualty Claims in a commercial insurance environment
Experience in Claims Management process
Knowledge of Property & Casualty forms and coverages for proper claims reporting
Strong communication skills, both verbal and written required
Proficient with Microsoft Excel, Word, PowerPoint, and Outlook

Nice To Haves

Bachelor’s degree is preferred
Applied Epic experience preferred, but knowledge of similar Account Management System (AMS) is acceptable
Must have appropriate state insurance license (Adjuster’s license preferred)

Responsibilities

Build relationships with Higginbotham Clients to help in facilitating management of their claims
Manage a diary of assigned claims to be monitored for proactive handling.
Tactfully communicate with assigned adjusters to maintain proactive momentum in assigned claims.
Maintain familiarity with State specific regulation governing worker’s compensation benefits.
Research and become familiar with mitigation programs offered by the various captive programs to help mitigate worker’s compensation claims.
Actively educate insured’s on both State specific regulation and mitigation programs offered by the various captive programs while assisting them to implement both.
Prepare and provide claim tracking information
Develop and implement innovative claims resolution processes
Assist HIG clients with disputed claims resolutions
Identify areas on processes to eliminate potential E&O claims
Review claims that are declined to identify E&O exposure
Coordination of claims management process to improve customer satisfaction
Participate in claims review process with producers, clients and service department personnel.
Provide education of the claims process to agency and client personnel
Manage claim information and review reporting process in Applied EPIC claims system
Receive and review new document claim information; manage notification process
Suspend information and follow up with adjuster to ensure claims has been assigned and is being resolved in a timely manner
Follow up with adjuster and insured to ensure timely resolution of claim and excellent customer service
Continually search for process improvements and/or enhancements to workflow; make recommendations for change where appropriate
Review documents issued by insurance company for accuracy
Respond to client and company requests for action and information on any claims-related matter