Senior Claims Examiner/Lead Claims Examiner - AIPSO
Johnston, RI
About the Job
AIPSO is a management organization and service provider for various insurance industry groups responsible for administering the residual market. We are a national organization that serves local customer needs. Centralization and standardization are key to many AIPSO services because of the inherent economies of scale and other efficiencies. However, our organization is based on customer focus and recognizes the need for flexibility in serving customer groups with diverse interests.
Essential Duties & Responsibilities
- Manage a caseload of Commercial claims by monitoring and providing direction and authority as needed to the contracted third-party claims administrator with reference to coverage determination, reserving, settlement, and service-related matters.
- Ensure adherence to company policies and procedures for claim handling and that contractually agreed upon service levels are met.
- Responsible for ensuring legal matters and potential litigation cases are promptly identified and coordinated with management and AIPSO Legal staff.
- Identify and review potential major claims or claims which require a higher level of authority. May assist with reporting, such as Large Loss Summary.
- Ensure the third-party administrator is properly handling and maintaining efficiencies as it relates to expenses for outside vendors, outside counsel, salvage yards, SIU services, subrogation services, etc.
- Conduct self-audits to ensure third party administrator compliance with established criteria.
- Review and communicate authority for reserving, settling, or denial of losses to the third-party administrator.
- May assist in training of additional claims staff and other personnel as needed.
Education:
Bachelor’s degree (BA/BS) from four-year college or university with supplementary insurance education preferred. CPCU or other insurance designations and/or additional appropriate experience may be considered in lieu of a degree.
Experience:
5 or more years of Commercial claims experience. Litigation experience is a plus. Knowledge of how to interpret a lease is a plus. Experience providing coverage analysis and demonstrated property casualty claim technical expertise. Residual market auto experience preferred.
Skills/Knowledge:
Bachelor’s degree (BA/BS) from four-year college or university with supplementary insurance education preferred. CPCU or other insurance designations and/or additional appropriate experience may be considered in lieu of a degree.
Experience:
5 or more years of Commercial claims experience. Litigation experience is a plus. Knowledge of how to interpret a lease is a plus. Experience providing coverage analysis and demonstrated property casualty claim technical expertise. Residual market auto experience preferred.
Skills/Knowledge:
- Demonstrate strong verbal and written communication skills, including ability to effectively present information and respond to questions from groups or individuals.
- Ability to manage multiple priorities and adapt to changes, including ability to manage multiple lines of business.
- Demonstrate excellent organizational skills.
- Effective problem-solving skills, including ability to analyze complex issues, find the root cause of the problem, and consider a wide range of alternatives before acting.
- Ability to work independently and interact professionally and effectively in a team environment.
- Adjusting licenses or ability to obtain required adjusting licenses.
- Knowledge of Insurance industry claims and insurance legal/regulatory environment.
- Proficient in the use of Microsoft Office productivity tools (e.g., Outlook, Word, Excel) to manage work, including policy management systems.
Salary Range:
$73,100 - $116,700/$79,600 - $127,200 Annual. Actual salary for this position will be determined by a number of factors, including the scope, complexity, and location of the role as well as the cost of labor in the market; the skills, education, training, credentials, and experience of the candidate; internal equity and other conditions of employment.
$73,100 - $116,700/$79,600 - $127,200 Annual. Actual salary for this position will be determined by a number of factors, including the scope, complexity, and location of the role as well as the cost of labor in the market; the skills, education, training, credentials, and experience of the candidate; internal equity and other conditions of employment.
AIPSO is an equal opportunity employer. To this end, all employment related decisions are made on a non-discriminatory basis and in full compliance with federal, state, and local laws prohibiting discrimination in employment.
Source : AIPSO