Senior Claims Specialist - Prime Specialty

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Regular or Temporary :

Regular

Language Fluency : English (Required)

Work Shift :

1st shift (United States of America)

Please review the following job description :

Analyzes and processes claims by gathering information and drawing conclusions. Acts as a liaison between insured and insurance carrier to report, track and manage claims process.

Provides leadership to all employees within the claims department.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below.

Specific activities may change from time to time.

1. Supervise a multi-person team ensuring all pertinent information is communicated.

2. Evaluate claims, reporting forms and cancellations and initiate necessary corrections to ensure accuracy of dates, coverage, signature, commission, premium, attachments, etc.

3. Authenticate all relevant activity on assigned files and makes recommendation for additional activity as appropriate.

4. Determine where new loss claims should be reported.

5. Manage all claim documentation.

6. Use discretion to submit the necessary information and / or correspondence to the Agent or Insurer to process claims appropriately.

7. Analyze claim coverage with insurance carriers to ensure claims are paid accurately.

8. Assess eligibility status of denied claims.

9. Anticipate and meets all customer needs (both internal and external).

10. Maintain claims and suspense system ensuring follow-up for receipt of policies, endorsements, inspections reports, correspondence, claims, etc. from outside sources.

11. Process all departmental claims in a timely manner according to company policy.

12. Facilitate the training of new employees in the department.

13. Provide supervision to Claims Assistants.

14. Perform other duties as assigned.

QUALIFICATIONS

Required Qualifications :

The requirements listed below are representative of the knowledge, skill and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Bachelor's degree with a concentration in business or equivalent work experience

2. Three years of Claims handling experience and commercial and multi-line knowledge

3. Ability to critically review a claim file for relevant information, accurately access the information and make necessary recommendations

4. Ability to make independent decisions following CRC guidelines with minimal or no supervision

5. Good organizational, time management, and detail skills

6. Extensive knowledge of insurance and CRC processes

7. Ability to maintain a high level of tact and professionalism

8. Good leadership skills to influence all departmental employees in a positive manner

9. Possess strong interpersonal skills

10. Strong verbal and written communication skills

11. Strong computer and office skills

12. Ability to work extended hours when necessary

Preferred Qualifications :

1. Adjusting experience

The annual base salary for this position is $120,000.00 - $140,000.00

General Description of Available Benefits for Eligible Employees of TIH :

All regular teammates (not temporary or contingent workers) working 20 hours or more per week are eligible for benefits, though eligibility for specific benefits may be determined by the division of TIH Insurance Holdings, LP (TIH) offering the position.

TIH offers medical, dental, vision, life insurance, disability, accidental death and dismemberment and tax-preferred savings accounts, along with other voluntary benefits.

All regularly scheduled teammates (not temporary or contingent workers), regardless of the number of scheduled hours, can contribute to a 401(k) savings plan and you become eligible for Company matching contributions after one year of service and attainment of age 21.

Teammates also receive no less than 10 days of vacation (prorated based on date of hire and by full-time or part-time status) during their first year of employment, along with 10 sick days (also prorated), and paid holidays.

For more details on TIH's generous benefit plans, please visit our Benefits site. Eligible employees may have the opportunity to participate in a deferred compensation plan and / or have an ownership interest in TIH in the form of profits interest or capital interest.

As you advance through the hiring process, you will learn more about the specific benefits available for any non-temporary position for which you apply, based on full-time or part-time status, position, and division of work.

This position is part of TIH.

Truist Financial Corporation has completed the sale of Truist Insurance Holdings (TIH). As a result, TIH is a separate company from Truist Bank as of May 6, 2024.

Refer to the news release for details.

CRC supports a diverse workforce and is an Equal Opportunity Employer that does not discriminate against individuals on the basis of race, gender, color, religion, citizenship or national origin, age, sexual orientation, gender identity, disability, veteran status or other classification protected by law.

CRC is a Drug Free Workplace.

EEO is the Law Pay Transparency Nondiscrimination Provision E-Verify