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Senior Risk Management Claims Specialist

Employer
OneGroup
Location
Syracuse, New York
Salary
Competitive salary & Benefits Package - Flexible Work Environment - Opportunity For Growth
Closing date
Jun 26, 2022

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Job Details

JOB SUMMARY:

 

The Risk Management Claim Representative handles the claim intake process between OneGroup clients and the insurance carrier. Oversee all aspects of the claims handling process, implements claim handling instructions for retail agency clients and acts as a liaison between the insured and insurer for all lines of coverage to include workers’ compensation, commercial property, general liability, auto and professional liability. Routinely monitors the claim handling, reserves and action plans and reports back to insured and producer. Coordinate and participate in face to face claim reviews, provide follow up action plans. Evaluates risk assessments, claim handling instructions, and negotiates reserves and settlement plans on behalf of insured. Performs Annual Stewardship Results and assists in client Service Planning.

 

ESSENTIAL DUTIES AND RESPONSIBILITES:

  • Provide overall claims service strategy and carrier/TPA claims service coordination for risk management clients.
  • First point of contact for clients when reporting a claim to insurance carrier.
  • Review loss reserves for clients and prospects to determine accuracy of current reserves and opportunities to mitigate claims costs.
  • Negotiate with carriers regarding claims handling and reserves.
  • Work with carriers to recommended case closure strategies and negotiate lower reserves when appropriate.
  • Monitor impact of claim risk management services on reserve reduction and experience modification factor.
  • Meet with large clients to perform periodic claim reviews and overall claim performance statistics.
  • Analyze current reserving and claims management strategies for workers compensation clients.
  • Oversee the experience modification factor review process for the agency.
  • Provide oversight and central point of contact for the agency’s claim tracking and risk analysis program.
  • Monitor carrier’s adjuster performance in accordance with agency published standards.
  • Notify insurance carriers of any reserve discrepancies soliciting management assistance when necessary.
  • Provide education programs to clients and prospects regarding claims management services.
  • Develop marketing materials for Claims Risk Management Services.
  • Develop and present Claims Risk Management service contracts for prospects.
  • Review declination of coverage and review policies and facilitate coverage opinion
  • Support sales process by attending presentations and initial sales calls where appropriate.
  • Support marketing of claims risk management services on a contract basis.
  • Interact with vendors for Claim Management and Risk Analysis Software.
  • Participate in seminars and classes for skill and knowledge development.
  • Other related duties as assigned.

 

MINIMUM QUALIFICATION REQUIREMENTS:

 

Education:

  • Associate Degree in Claims or other two (2) year degree preferred

 

Professional Certifications/Licenses:

  • AIC Designation or equivalent insurance designation
  • Property/Casualty License preferred

Experience/Skills:

  • 5+ years’ of multi-line claims handling experience; workers’ compensation, commercial property, general liability, auto, professional liability preferred
  • Exceptional risk management and claims management skills related to Workers Compensation 
  • NYS & NCCI Experience Rating experience
  • Excellent interpersonal communication and relationship building skills to include strong negotiation skills
  • Solid statistical analysis skills
  • Ability to work independently 
  • Excellent writing skills
  • Proficiency in Microsoft Word, Excel and PowerPoint

 

Company

ONEGROUP is a leader in risk management, insurance and business solutions. Our difference is our more than 200 experts and specialists working seamlessly to benefit our clients...with a single call. OUR VISION To create ONE company acting as ONE team with ONE focus and ONE mission: to serve each client as our ONE client.

CORE SERVICES: Workers’ Compensation Specialists Professional & General Liability Insurance Personal Home, Auto and Valuables Insurance Risk Management Consulting Commercial Insurance Employee Benefits Employee Benefit and Human Resources Consulting Independent Medical Examinations Occupational Health Networks Hiring Protocols Injury Management / Return to Work

Specialties

Workers'​ Compensation, Risk Management Consulting, Employee Benefit and Human Resources Consulting, Professional & General Liability, Personal Home, Auto Insurance, Occupational Health Networks, Health Insurance, Financial Services, FSA and HSA Services, Umbrella Insurance, RFP Design and Facilitation, and Disability Insurance

Company info
Website
Telephone
3153998513
Location
706 North Clinton Street
Syracuse
NY
13204
US

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