Manages commercial insurance claims for clients and portfolios, including claim reviews, reserves, settlements, coverage disputes, and risk mitigation. Establishes claims protocols with carriers and clients, advocates for cost reduction, develops claims management solutions, and communicates findings and recommendations. Serves as a technical mentor and supports client meetings, renewals, and business development through claims expertise.
The Claims Executive is considered an expert in managing insurance claims on an individual and portfolio level for our clients, and is utilized as a trainer, mentor with their technical expertise. They must be able to execute with little to no tactical supervision; have knowledge and experience in claims handling and risk mitigation techniques. They are able to develop relationships and effectively communicate with a diverse range of clients, carriers and colleagues. They will engage as an extension of our client(s) to simplify the course of a complex claim and assist with navigation and efforts to resolve claims disputes or issues that may occur. They will partner with client(s) to evaluate, identify, design, implement, and measure claims management solutions to reduce their total cost of risk.
PRIMARY RESPONSIBILITIES:
- Works with insurance company partners and clients in establishing claims protocols and or policy enhancements that ensure proper reporting, notification, settlement, defense, etc.
- Schedules and conducts claim reviews with clients and insurance company partners ensuring proper claims handling, reserve standards and settlement protocols.
- Act as a claims advocate and liaison for clients interested in mitigating claims costs.
- Regularly reviews individual claims within client portfolios and keeps reserves and records up-to-date and according to industry best practices.
- Serves as a mentor to colleagues as requested.
- Develops an understanding of marketing strategies and contributes to business development and renewal opportunities by attending client meetings to explain the firms approach to claims mitigation and resolution.
- Remains well-informed of industry trends and best practices with regards to claims management, claims/outcomes, legal and regulatory changes, etc.
- Provides summaries of claims reviews, activities, etc. to appropriate Advisors, Director of Risk Mitigation and other colleagues and clients as necessary.
KNOWLEDGE, SKILLS & ABILITIES:
- Possess strong knowledge and/or expertise with claims management of various commercial claims including workers compensation, property & casualty, management liability, professional liability and/or other specialty claims.
- Ability to motivate and influence colleagues and clients; the role of teacher, trainer, and mentor cannot be overemphasized.
- Works as part of a team of professionals and builds relationships with our firm's business segments.
- Communicates verbally and in writing to all levels of the firm and to a diverse group of clients.
- Presents solutions, value propositions and risk mitigation strategies to colleagues, clients and prospects.
- Utilizes industry best practices to develop claims management strategies and services that serve a broad spectrum of clients within multiple industries.
- Reads and interprets documents such as coverage and reservation of rights letters, profit and loss statements, safety rules, operating instructions, and procedure manuals.
- Experience with policy coverage review and dispute resolution.
- Speaks effectively to groups of customers or colleagues of an organization. Knowledge and understanding of the Spanish language, a plus.
- Applies common sense understanding to carry out instructions furnished in written, verbal, or diagram form.
- Strong computer skills including Microsoft Excel and Word.
- Demonstrates the organization’s core values, exuding behavior that is aligned with the firm’s culture.
EDUCATION & EXPERIENCE:
- Bachelor's degree preferred. 10+ years experience with claims and client/customer facing support role in the insurance industry.
- Would expect at least one if not more of the following certifications: AIC, CPCU, ARM, CIC, AINS, WCCP, CLRI, CRM, PRM,
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The Baldwin Group will not accept unsolicited resumes from any source other than directly from a candidate who applies on our career site. Any unsolicited resumes sent to The Baldwin Group, including unsolicited resumes sent via any source from an Agency, will not be considered and are not subject to any fees for any placement resulting from the receipt of an unsolicited resume.
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