Executive Claims Specialist

Job Type

Full-time

Description

HDI Global Insurance Company is a rapidly expanding Insurance Company, with offices throughout the world, we can provide insurance solutions for our clients in over 160 countries.

We are hiring an Executive Claims Specialist , who will be responsible for day-to-day supervision of programs or captives whose claims are handled by a Third-Party Claims Administrator (TPA).

The Executive Claims Specialist will own account management and provide support to both HDI and TPA personnel. They will manage relationships with TPAs to ensure compliance with HDI contracts, Account Handling Instructions, and Industry Best Practices.

Essential Functions

• Identify and proactively address TPA issues to ensure highest levels of service.
• Communicate directly with TPA to address and resolve issues or concerns and to resolve complaints.
• Audit a representative sampling of each TPA and program's claims at least once per year, including formal written report and meeting to present results.

Monitor action plans generated by the audits to drive improvement.

Ensure that claims are being processed as expeditiously as possible, and that all inventories are regularly reviewed, and all possible actions are taken to move the claims to closure.

This involves review of aging inventory and other reports to identify problems and to take corrective action.

• Work with HDI Claims team to constantly improve TPA claim handling processes, systems, communications and overall program effectiveness.
• Respond to correspondence from TPA's.
• Provide guidance and direction to TPA's on complex claim handling, strategy or negotiation and resolution.
• In event of a catastrophe that requires a ramp-up and response, support efforts to prepare the staff.
• Accomplish tasks in a dynamic environment with an aptitude for analyzing data and making practical and forward-looking decisions to drive success.
• Work on intra-departmental teams, collaborating and participating to deliver solutions.

Requirements

• Bachelor's degree preferred; Industry certifications or designations a plus
• 5+ years of commercial claims experience and 3+ years of program supervision experience
• Previous Program or TPA supervision experience for P&C carrier strongly preferred
• Strong organizational, critical thinking, problem solving, analytical, and quantitative skills including the ability to analyze and interpret financial and claims data.
• Excellent oral and written communication skills, including ability and experience supporting strategic initiatives
• Proficient computer and typing skills; working knowledge of Microsoft Office Suite.
• Ability to work effectively within numerous claims systems.
• Adjuster licensing in all required states

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HDI Global is an Equal Opportunity Employer

Individuals seeking employment at HDI Global Insurance Company are considered without regards to race, color, religion, national origin, age, sex, marital status, ancestry, physical or mental disability, veteran status, gender identity, or sexual orientation.

HDI Global Insurance Company participates in E-Verify.