CL Claims Specialist II
General Description: Manage claim administration functions for clients of the business.
- Conducts claim reviews and negotiates with carriers for claim services.
- Advanced understanding of at least two lines of coverage relative to claims management strategies, resolution techniques & coverage forms ( generally WC & Liability)
- Ability to use carrier / TPA claims management systems to generate reports that provide loss information and some level of trends / analytics.
- Ability to identify client issues, build a plan towards resolution, execute and manage internal and external expectations effectively.
- Understanding of loss ratios and general understanding of loss impact on premium.
- Higher-level technical administrative ability with use of Microsoft Suite, ability to produce user friendly documents through internal resources.
- Strength in communication internally and with clients at various levels within the client organization.
- Plan and organize workflow and meetings with clients in an independent manner.
- Responsible for claim advocacy and negotiation, including claim denial review, reservation of rights review, and claim reporting.
- Analyzes claims based on a best practice outline and partners with other members of the technical resource team.
- Responsible to assist members of the USI team with "Close" and "Keep".
Knowledge, Skills and Abilities:
- Superior written and oral communication skills.
- Ability to work well in a team environment.
- Must have strong analytical thinking and problem-solving skills.
- Strong organizational skills required.
- Strong negotiation skills required.
- Ideal candidate will have a minimum of three to five year of claims administration experience.
- College degree preferred but high school diploma or graduate equivalent degree required.
- Proficient-to-expert in MS Office suite of products.
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