Frisco, TX, USA
35 days ago
Senior Claims Specialist

About Specialty Program Group: Our goal is to partner with industry-leading specialty businesses to provide them with the ability to achieve their goals and optimize their businesses. Specialty Program Group offers access to capital and investment, deep carrier relationships, creative thinking, product development and broad distribution, while allowing our businesses to maintain the essence of what makes them successful. Specialty Program Group delivers leading-edge specialty expertise backed by transformative digital capabilities and sophisticated data and analytics. 

About SCIS: Our in-house team includes deeply experienced, regionally located underwriters who average over 20 years of specialty workers’ compensation experience, as well as licensed claim advisors and premium audit specialists. This team is complemented by access to industry leading safety, loss control and claim services experts to provide you and your clients with best-in-class, real-time solutions that help mitigate exposures and contain costs.
 

Job Summary

The Sr. Claims Specialist is responsible for helping to oversee the claim’s technical process in conjunction with the organization’s carrier partners and third party administrators.  The Sr. Claims Specialist is involved in the overall design, implementation and completion of claims and safety programs and policies. The SCS is a subject matter expert on all work place injury compliance and acts as a liaison between our clients and insurance partners.

Key Responsibilities:

Acts as a liaison between policyholders, insurance companies, agents and brokers in in the management of Workers compensation claims.

Review of new claims and policy documents to understand: Mechanism of injury,  Validity of claim, Near misses, Subrogation opportunities

Review large reserve changes thoroughly

Create and send large loss reports to underwriting and management

Escalate severe and or difficult claims to management

Prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties etc...

Review progress and status of claims with Advisory Services Manager and discusses problems and suggested remedial actions.

Create and send monthly, quarterly or semi-annual loss runs per client profile

Create and send quarterly or semi-annual claim status reports per client profile

Organize quarterly or semi-annual file reviews per client profile

Participate in all file reviews to assess progress, make recommendations and ensure proper communication between policyholders and claims technical team

Establish and maintain strong customer relationships

Maintain the program’s service logs

Review and Triage new claims in an effort to identify risk management deficiencies and develop plans of action.

Coordinate action plans with Third Party Adjusters.

Acts as a liaison between carrier partners, policyholders and brokers.

Identify gaps in risk management processes and make suggestions for improvement.

Analyze claims data and create stewardship reports for clients.

Desired Qualifications:

1-3 years’ experience handling workers’ compensation claims.

Basic knowledge of claims handling and familiarity with claims terminologies

Strong communication and interpersonal skills to be capable of dealing with customers, insureds, and brokers in a positive manner concerning losses.

Ability to self-motivate and work independently

Knowledge of company products, services and coverage’s, along with awareness of the company’s claims best practices

Knowledge of applicable state and local laws

Bachelor’s Degree of Equivalent Experience

Licensed Adjuster in Workers’ Compensation or All Lines

Claims experience in multiple jurisdictions

Disclosure required under applicable state or municipality regulations: The expected salary range for this position is $70,000 to $80,000 and will be impacted by factors such as the successful candidate’s skills, experience and working location, as well as the specific position’s business line, scope and level. HUB International is proud to offer comprehensive benefit and total compensation packages which could include health/dental/vision/life/disability insurance, FSA, HSA and 401(k) accounts, paid-time-off benefits, and eligible bonuses, equity and commissions for some positions.

#SPG

Department Claims Management

Required Experience: 1-2 years of relevant experience

Required Travel: No Travel Required

Required Education: Bachelor's degree (4-year degree)

HUB International Limited is an equal opportunity and affirmative action employer that does not discriminate on the basis of race/ethnicity, national origin, religion, age, color, sex, sexual orientation, gender identity, disability or veteran's status, or any other characteristic protected by local, state or federal laws, rules or regulations. The EEO is the Law poster and its supplement is available here at http://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm .

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