Claims Specialist - Accident and Health

Primary Details

Time Type: Full time



Worker Type: Employee

Claims Specialist - Accident and Health

• Location: USA – MA –Marblehead
• Work Arrangement: Hybrid
• The salary range for this role is: $75 - $128,000
  
  
  
  

The Opportunity

Manage a portfolio of moderately complex claims by conducting loss investigations, evaluations and settlements on moderate to high level claims for assigned line(s) of business. Assures timely and accurate reserves. Effective communication and collaboration with Underwriting, Actuary, Legal and Risk. Working within specific limits and authority, conduct and coordinate loss investigations on moderately complex claims to provide accurate facts for disposition.

Your New Role

• Appropriately administer insurance coverage to moderately complex claims by conducting loss investigations, analyzing factual information, interpreting insurance policies and applying legal and technical knowledge to independently resolve claims files in a timely manner
• Negotiate claims settlements by collaborating with subject matter experts and involved parties, recommending appropriate reserve modifications for assigned claims and communicating solutions to mitigate risks and coverage conflicts and achieve cost effective outcomes
• Inform internal and external stakeholders on claims resolution processes by summarizing factual information, reporting out of scope, specialized exposures and accurately managing documentation of assigned claims to ensure effective communication of current state for individual claims portfolio
• Build strong working relationships by reporting on approved, cost-effective claims strategies to ensure understanding of Claims operations and encourage a collaborative approach to enhancing the business
• Support claims workflow efficiency by accurately documenting portfolio progress, referring high risk exposures outside authority levels and seeking opportunities that enhance operational knowledge to ensure achievement of individual and department objectives
• Contribute to a positive work environment by demonstrating cultural expectations and influencing others to reward performance and value “can do” people, accountability, diversity and inclusion, flexibility, continuous improvement, collaboration, creativity and fun
  
  
  
  

Required Education

• Bachelor's Degree or equivalent combination of education and work experience
  
  
  
  

Required Experience

• 3 years relevant experience
  
  
  
  

Required Licenses/Certifications

• Obtain and/or maintain state adjusting licenses as necessary
  
  
  
  

Preferred Competencies/Skills

• Utilize effective communication to effectively influence and persuade decision makers; understand the needs and goals of customers and actively look for ways to meet them
• Mediate and resolve conflict using a logical approach
• Identify relevant information and understand it’s impact
• Maintain integrity of claims portfolio and evidence
• Use multiple resources to gather and analyze significant data
• Leverage technical knowledge to make cost-effective decisions
• Encourage open communication, cooperation and knowledge sharing
• High attention to detail
• Implement planning to organize, prioritize and measure individual work
  
  
  
  

Preferred Experience

• Experience in a claims department or the insurance industry
• Familiarity with interpretation of contracts and negotiation
• Experience in agency, retail or wholesale brokerages, third-party administrator, risk management, legal or other roles
  
  
  
  

Preferred Knowledge

• Knowledge of claims administration best practices and procedures
• Knowledge of insurance products and services
• Understanding of relevant laws and regulations across multiple jurisdictions
• Understanding of market trends and organizational strategies
• Knowledge of Microsoft Office Suite, general computer software and database systems
  
  
  
  

Compensation Package: The salary range for this role is provided above. The salary offer will be decided based on the role's complexity, its location, and the candidate’s professional background, including their education and experience. Beyond the base salary, regular full-time and part-time employees will also be eligible for QBE’s annual discretionary bonus plan based on business and individual performance. 

Benefits

• Hybrid Working – a mix of working from home and in the office.
• 22 weeks of paid leave depending on the circumstances in growing your family with 12 of those weeks available to all parents, on a gender-equal basis
• Competitive 401(k) program with company match up to 8%
• Well-being Programs: Enjoy monthly Guided Meditations and a Well-being Rebate Program for gym memberships, fitness programs, and more.
• Tuition Reimbursement for continuing education through certifications, external professional development and degree related college courses.
  
  
  
  

To learn more, click here: Benefits | QBE US.

Why QBE? What if you could have a positive impact – at work and in the world?



At QBE, we’re enabling a more resilient future – for our customers, communities, environment, and for our people. We’re building momentum to achieve something significant and know our people are at the center of our success.

Our industry offers interesting and varied careers where you can help people to protect what matters most. As part of the QBE team, you’ll get to spend every day working with people who are passionate, talented and kind. And our international scale means we’re big enough for your ambitions, yet small enough for you to make a real impact.

Join us now, so you can be part of our success – and we can be part of yours!

https://www.linkedin.com/company/qbe-north-america/

Commitment to Diversity



At QBE, we are deeply committed to fostering an inclusive workplace where each person is valued and respected for their authentic selves. If you require any assistance, such as alternative interview accommodation during the recruitment process, please do not hesitate to inform our Talent Acquisition team.

Equal Employment Opportunity:

QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.

Skills:

Analytical Thinking, Business Process Improvements, Claims Settlement, Critical Thinking, Customer Service, Insurance Analysis, Insurance Claims Management, Insurance Policies, Intentional collaboration, Managing performance, Negotiation, Problem Solving, Risk Management, Sound Judgment, Stakeholder Management

How to Apply:

To submit your application, click "Apply" and follow the step by step process.

Equal Employment Opportunity:

QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.