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Claims Specialist

Claims Specialist

Ocean StateNorth Kingstown, RI, US
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Claims Specialist

The Claims Specialist role at Ocean State Job Lot ("OSJL" and "Company") reviews claims for irregularities, accuracy, and completeness. This role ensures claims eligibility, requests necessary additional information, and maintains up-to-date records. The role also assists with cost control, prepares required reports, and communicates with individuals about their claims, including providing counsel on benefit amounts.

Key Responsibilities :

  • Claims Management & Processing : Manage the entire claims lifecycle from intake to resolution which involves the exercise of discretion and independent judgment on significant matters, including screening new reports, collaborating with stores to gather information for investigations, and ensuring the insurance carrier handles claims in a timely manner. Handle new reports that do not require carrier involvement, adhering to internal procedures.
  • Liaison & Communication : Serve as a key liaison between customers, OSJL, and the insurance carrier. Provide excellent customer service while facilitating communication between all parties.
  • System & Financial Administration : Assist with managing and tracking Certificates of Insurance in the Origami risk management system and monitoring the company fleet. Assist with invoice processing and related financial tasks within Oracle.
  • Risk Mitigation : Identify potential liability exposures related to injuries and damages, and make recommendations for remedial action.
  • Project Support : Participate in various projects and assignments to support the overall function of the Risk Management Department.

Qualifications :

  • Degree preferred and / or equivalent work experience.
  • Some knowledge of insurance and claims is a plus.
  • Excellent communication (both written and oral), problem-solving, and organizational skills are required.
  • A strong understanding of general liability and the ability to make critical decisions are preferred.
  • Experience working with Third Party Administrators (TPAs) is a plus.
  • Self-motivation and a strong ability to work independently, multitask, and manage competing priorities effectively are required.
  • Proficient in Google platform (i.e., Sites, Slides, Drive, Docs, Sheets).
  • Work Environment :

  • May involve exposure to challenging customer and associate interactions.
  • Works primarily in a climate controlled environment with minimal safety and health hazard potential.
  • Works in an office environment remaining stationary at a desk, table, or computer workstation for extended periods of time. Frequently uses near vision for reading and computer tasks.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
  • Hybrid work option : Some work may be completed outside of the Company locations, with at least three (3) days a week in the Corporate Office. The role is responsible for setting up a professional and ergonomically safe work environment and to be available during working hours. Hybrid work options are not guaranteed and are subject to change at any time based upon Company policy, associate performance and business needs.
  • OSJL Featured Total Rewards & Perks :

  • Competitive Paid Time Off (PTO)
  • Comprehensive Health Coverage : Including but not limited to Medical, Dental, Vision, and much more.
  • 401K Program
  • Flexible Spending Account (FSA)
  • Tuition Reimbursement
  • Associate Store 30% Discounts
  • Enjoy complimentary access to OSJL-owned vacation properties, along with discounted gym memberships and 20% off at OSJL affiliated restaurants.
  • Free lunch Fridays
  • The annual salary for this position is between $55,000 - $65,000. Salary commensurates with qualifications and years of experience.

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    Claim Specialist • North Kingstown, RI, US

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