Lead Claims Advocate

Risk Strategies•Boston, MA

5d•$67,000 - $130,000•Hybrid

About The Position

The Lead Claims Advocate will handle all insurance claim matters presented by clients of Risk Strategies Inc., and affiliates, in accordance with objectives and procedures outlined by management. This role involves receiving newly created losses, confirming appropriate policy coverage, reviewing claim circumstances, communicating preliminary coverage opinions, and advocating for the client throughout the claims process. The Lead Claims Advocate will manage claim files, maintain active diaries, transmit documentation, and follow up with clients and carriers. They will also meet with clients, assist in claim submission, attend on-site loss inspections, field client questions, act as a mediator with carriers, and provide information to adjusters and other personnel. Additionally, this role involves reviewing lawsuits, pursuing professional development, handling Account Executive inquiries, conducting client claim reviews, and responding to emergency calls during off-hours. The Lead Claims Advocate will also perform Strategic Claim Reviews and work in conjunction with Defense Counsel on litigated files, including attending mediations.

Requirements

Valid P&C Brokers’ license or adjuster license
Minimum of 7-10 years of experience as a specialist in dedicated industry
Advanced knowledge of Property & Casualty coverage
Extensive knowledge of multi-line coverage and how coverage applies to different losses
Proficiency in computer applications, esp. Microsoft Office Suite
The ability to provide superior customer service
Excellent client advocacy and negotiation skills
Excellent verbal and written communication skills
Exceptional organization and time-management skills

Nice To Haves

College degree (preferred)

Responsibilities

Receive newly created loss and confirm that the claims are filed under the appropriate policy(ies)
Review circumstances surrounding claims along with appropriate coverage and verbally communicate preliminary coverage opinion to the client
Acknowledge receipt of claim to client in writing and request all documents necessary in order to move forward and properly advocate on client’s behalf
Keep claim file properly updated and attach documents in accordance with protocols created and set within the department
Handle to conclusion insurance claims presented by clients and/or as assigned by Claims Team Leader
Duties include advocating for the client, maintaining an active diary, transmittal of documentation, follow up calls, and emails to the client and carrier
Meet with clients when necessary
Assist client in assembling and submitting their claim to the carrier
Attend on-site loss inspections when necessary
Field client questions and complaints and act as mediator with the carrier when necessary
Provide information for adjusters and other company personnel as requested
Provide insured with interim and final settlement information
Review lawsuits submitted by clients prior to filing with carriers
Pursue programs for personal and professional development
Handle Account Executive inquiries, provide information and internal loss runs when necessary
Conduct and/or attend client claim reviews as requested by Producers and Account Executives
Perform other duties/projects as assigned by Claim Team Leader
Whenever necessary, be prepared to respond to emergency calls from our clients during off hours (i.e. evenings, weekends, and holidays)
Perform Strategic Claim Reviews working in turn with Loss Control and Analytics
Work in conjunction with Defense Counsel on litigated files if need be
Consult on litigated files when needed including attending mediations etc.