Support PDF,DOC,DOCX,TXT,XLS,WPD,HTM,HTML fils up to 5MB
Years of Experience
Date Last Verified
ProfileClaims Advocate II The candidate will be responsible for providing claim advisory client services independently or in combination with others to ensure the most equitable return on the clients insurance investment, while minimizing the impact of adverse events on their business. Serves as senior advocate to less experienced colleagues. Frequently involved in the more complex client engagements and issues. Reporting claims using company’s proprietary claim platform Claim in compliance with company Professional Standards. Reporting Claims, Losses and Lawsuits as directed in Client Service Agreements/Letters of Engagement. Facilitates the establishment of client’s loss handling instructions with claim administrator including guidance in direct reporting of claims. Evaluates coverage applicability of all company placed business, assisting client with insurer coverage negotiations and escalation of those issues where appropriate to managing claim advisors. Assesses client needs or claim trends, identifying and solving problems with innovative and practical solutions and utilizing MCP, company Risk Consulting or MMC services to meet those needs. Oversight of claims processes including monitoring time sensitive policy provisions to ensure appropriate and timely processing of payments by the carrier or third party administrator. Solicits and contributes written communication of Claim success stories from self and team. Assists client with claim preparation, presentation, management and settlement strategies including litigation management issues that impact claim settlements. Facilitate claim reviews and contribute to same with in-depth claim knowledge to help expedite resolution of claims. Responsible for the development and securing target service hours for MCP work plans and adheres to budget requirements with alerts to Client Executive's regarding budget erosion & additional revenue opportunities. Develop and maintain market relationships with Third Party Administrators and carrier contacts at local and senior national levels. Seek growth opportunities for the firm through MRC referrals and participation in written responses to RFP’s and oral presentation of claim services to prospects and clients. Manage and participate in catastrophic claim responses. Keeps client teams and company management apprised of status of any current claims or client issues as identified by self or team. Supports company colleague engagement, executing company talent management responsibilities and providing coaching, mentoring and sharing of knowledge with other colleagues. Assists brokerage with policy wording review and assist in developing appropriate policy language to address client risk issues. Understands insurance program structures as they relate to the claim process and assist brokerage in renewal and LOC management. Understands and complies with company’s professional standards to avoid potential E&O claims. Utilization of cost effective practices to reduce appropriate expenditures and identification of opportunities within the firm to improve efficiencies, create additional capacity and provide value added service to clients. Must have licensing according to company policy or applicable law. Should have 8+years of Casualty claims experience and technical knowledge. Demonstrated technical proficiency in required specialty.