Claims Specialist

Claims Specialist

The Claims Specialist will review, analyze, and decide the proper submission path for all First Notice of Losses (FNOL) sent to our firm for prompt adjudication. Additionally, they will assist in the development and creation of underwriting review submissions along with internal and external client/customer claim related correspondence under the guidance and supervision of a Claims Consultant. In addition, the candidate will have best in class client servicing and communication skills enabling them to work with minimal supervision in a dynamic environment.

PRIMARY RESPONSIBILITIES:

• Review and analyze First Notice of Losses (FNOL) received by assessing the nature of the claim and determining the proper submission path for prompt adjudication.
• Collaborate with a Claims Consultant to develop and create underwriting review submissions, ensuring accurate and comprehensive documentation.
• Under the guidance of a Claims Consultant, assist in preparing internal and external claim-related correspondence, maintaining clear and effective communication with clients and customers throughout the claims process.
• Ensure compliance with industry standards, company procedures, and regulatory requirements while handling claims and maintaining confidentiality of sensitive information.
• Provide exceptional client servicing, addressing inquiries, concerns, and providing timely updates to clients and customers regarding claim status and resolution.
• Maintain accurate and detailed claim records, documentation, and electronic files in compliance with established procedures.
• Stay updated on industry trends, emerging regulations, and best practices in claims management, continuously enhancing knowledge and expertise.
• Contribute to process improvement initiatives, suggesting enhancements to streamline claim handling, increase efficiency, and enhance customer satisfaction.
• Handle other related duties and responsibilities as assigned by the Claims Consultant or management.

KNOWLEDGE, SKILLS & ABILITIES:

• Ability to drive a claim from first intake through the process to satisfactory submission of the first notice of loss.
• Ability to work independently and prioritize assignments, seeking guidance where needed.
• Supply the highest quality support to customers through effective communication, diligence, organization, and diligent follow-up.
• Effective communication skills, both oral and written, with the ability to be professional under pressure and display patience above reproach.

EDUCATION & EXPERIENCE:

• At least two years of experience desired within a client/customer facing or support role is preferred.
• Proficient in MS Office Word and Excel with the ability to learn new system programs and technologies.

IMPORTANT NOTICE: This position description is intended to describe the level of work required of the person performing in the role and is not a contract. The essential responsibilities are outlined; other duties may be assigned as needs arise or as required to support the organization. All requirements may be subject to reasonable accommodation to applicants and colleagues who need them for medical or religious reasons.