Program Claim Specialist (Hybrid: Madison, WI)
About The Position
The Program Claim Specialist oversees assigned Program Third Party Administrators (TPAs) and handles new and existing litigation claims, including complex professional and general liability litigated claims. The role ensures timely and effective application of policies and processes and is accountable for team goals related to customer service and compliance with best practices. It provides claim-file direction and assistance with complex claim issue resolution while maintaining effective communication with internal and external business partners. The position participates in quality assurance reviews and special projects, contributes to functional and team strategy, and works with cross-functional partners to analyze and structure existing and new Program Business. It also supports TPA selection and ongoing management, monitors claims processes and data practices, and identifies claim trends and process improvements. The position is hybrid in Madison, Wisconsin, with travel of approximately 10% as required.
Requirements
- 7 or more years of Property and Casualty insurance claims experience.
- Adjuster license and continuing education as needed.
- Ability to clearly and effectively communicate information to internal and external clients remotely or in person.
- Strong critical-thinking and analytical skills.
- Demonstrated experience in progressively senior claim roles with strong technical skills.
- Experience across Property and Casualty lines and products, including Property, General Liability, Automobile Liability and Physical Damage Liability, and Professional Liability.
- Strong interpersonal and consultative skills.
- Creativity, flexibility, emotional intelligence, adaptability, and problem-solving skills.
- Ability to manage and develop existing and new industry relationships with Program Managers, Brokers, and Reinsurance partners.
- Ability to travel approximately 10%.
Nice To Haves
- Bachelor’s degree in Business Administration, Insurance, Finance, Economics, or a related field of study is strongly preferred.
- CPCU, AIC, ASLI, or other industry designations or certifications are highly desirable.
Responsibilities
- Serve as the primary point of contact and relationship manager for program claims.
- Proactively manage assigned litigated claims, including investigation, evaluation, and negotiation through resolution.
- Coordinate operational and leadership responsibilities to support consistent claim results, quality, and customer service.
- Develop protocols for establishing and maintaining claim strategies and appropriate claim-handling authority, providing education and training as needed.
- Collaborate with business partners to vet and onboard new Programs and TPAs.
- Monitor and improve communication of essential claim information, ensuring monthly data collection and information-sharing practices support TruStage Corporate standards.
- Work with Underwriting, Actuarial, Product, Finance, and Treasury teams to analyze and structure existing and new Program Business.
- Conduct in-person or remote claim-file reviews and audits across multiple TPA claim systems.
- Travel as required to participate with Program Managers, Brokers, Reinsurance Intermediaries, claim TPAs, and other clients, including industry association meetings and conferences.
- Identify emerging claim trends as warranted.
- Monitor and document claim processes and guidelines for effectiveness and efficiency, identifying and implementing process improvements.
- Participate in Claim organization strategy initiatives and projects in collaboration with the Claim Operations team.
- Collaborate with Claim Operations leaders on selection and ongoing management of TPAs and other outside vendors.
Benefits
- Medical, dental, and vision benefits
- Employee assistance program
- Life insurance
- Disability plans
- Parental leave
- Paid time off
- 401(k)
- Tuition reimbursement
- Potential eligibility for an annual incentive (bonus) plan
- Flexible workplace supporting work-life balance, career growth, and retirement assistance
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What This Job Offers
Job Type
Full-time
Career Level
Senior
