Claims captive point person for captive specific service issues, processes and claims consultation. Oversight of CRI captive claims team and provide service and support to large/complex members. Evaluate large and/or complex claims and litigated matters across several captives, review significant coverage letters and communicate claim issues to both internal and external customers. Assist in significant customer service issues across all members and provide internal and external training.
ESSENTIAL EDUCATION AND EXPERIENCE:
Bachelor’s or Law Degree and at least seven (7) years of experience handling litigated general liability claims including construction defect and/or products liability claims. Insurance coverage and risk transfer experience are mandatory and workers compensation experience a plus. Team lead experience is also preferred.
SKILLS/COMPETENCIES REQUIREMENTS:
- Strong team attitude.
- Proficient in Microsoft office, especially PowerPoint and excel, ability for proficiency in claims RMIS systems.
- Interpersonal/communication skills.
- Excellent written and verbal communication skills.
- Comfortable presenting to audiences of all sizes.
- Organization, planning and prioritization skills.
- Strong analytical, problem solving and judgment skills.
- Strong customer service orientation.
- Commitment to company values.
- Willingness and ability to travel as required to support domestic client workshops and some international travel for board meetings. Generally, travel dates are known and planned well in advance.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:
Other duties may be assigned to meet business needs.
- Lead of CRI captive claims team (coordination of new member assignment, Board book materials, Captive Executive communication, etc)
- Oversee large complex claims; discuss and/or provide internal summaries.
- Understand and present the impact of a complex claim to internal and external customers.
- Review significant coverage decisions and assist with communicating carrier positions to members; communicate with carriers to ensure due diligence was completed.
- Review complex files, contracts and case law to assess coverage issues.
- Evaluate claims for errors and omissions potential and present to TPA or carrier.
- Identify internal and external training needs, develop and deliver presentations.
- Oversee claims services provided by TPA and carrier partners and evaluate and manage member claims service satisfaction.
- Address member questions and concerns with claims handling through working with adjusters and claims account management; and, where appropriate, work with CRI vendor management.
- Support member education and training by supporting/hosting workshops with appropriate topics and speakers.
- Report to captive board members on claims matters impactful to the captive at board meetings, as well as manage discussions regarding member satisfaction with claims handling.
- Set up new clients with the claims administrator and conduct appropriate onboarding on the captive claims processes and resources available.
- Monitor the claim service program of each client on an as needed and ongoing basis.
- Act as liaison between the client, the broker and claims administrator on any claim matter.
- Work closely with captive clients to drive engagement on claims and their appropriate use of available claims tools and resources including managing claims expenses.
- Monitor large value claims and other claims as requested by client.
- Notify CRI captive team of significant claims related issues and participate in captive team meetings.
- Coordinate and participate in claim reviews.
- Form positive member relationship; communicate adverse information effectively.
- Participate in department projects and support initiatives.
- Carrier and TPA relationship building.
- Prepare for and attend designated captive board meetings.
PRIORITIES:
Claims consultation, claims service problem solving, customer service, complex claim evaluation, communication, member and vendor relationships, Captive Executive and Claims Service Manager captive relationships.
