Senior Claim Specialist - Prime Specialty

CRC Group

1d•Onsite

About The Position

The Senior Claim Specialist analyzes and processes claims by gathering information and drawing conclusions. This role acts as a liaison between the insured and the insurance carrier to report, track, and manage the claims process. Additionally, the Senior Claim Specialist provides leadership to all employees within the claims department.

Requirements

Bachelor's degree with a concentration in business or equivalent work experience
Three years of Claims handling experience and commercial and multi-line knowledge
Ability to critically review a claim file for relevant information, accurately access the information and make necessary recommendations
Ability to make independent decisions following CRC guidelines with minimal or no supervision
Good organizational, time management, and detail skills
Extensive knowledge of insurance and CRC processes
Ability to maintain a high level of tact and professionalism
Good leadership skills to influence all departmental employees in a positive manner
Possess strong interpersonal skills
Strong verbal and written communication skills
Strong computer and office skills
Ability to work extended hours when necessary

Nice To Haves

New York adjuster license or New York attorney license
Three years of GL claims handling experience; New York Labor Law Sections 200, 240, 241 preferred.

Responsibilities

Supervise a multi-person team ensuring all pertinent information is communicated.
Evaluate claims, reporting forms and cancellations and initiate necessary corrections to ensure accuracy of dates, coverage, signature, commission, premium, attachments, etc.
Authenticate all relevant activity on assigned files and makes recommendation for additional activity as appropriate.
Determine where new loss claims should be reported.
Manage all claim documentation.
Use discretion to submit the necessary information and/or correspondence to the Agent or Insurer to process claims appropriately.
Analyze claim coverage with insurance carriers to ensure claims are paid accurately.
Assess eligibility status of denied claims.
Anticipate and meets all customer needs (both internal and external).
Maintain claims and suspense system ensuring follow-up for receipt of policies, endorsements, inspections reports, correspondence, claims, etc. from outside sources.
Process all departmental claims in a timely manner according to company policy.
Facilitate the training of new employees in the department.
Perform other duties as assigned.