The primary responsibilities of the Associate Claim Consultant is to handle the intake, day-to-day management, and high-level oversight of incidents, claims and suits for assumed reinsurance matters as well as excess-only matters where Coverys' layer sits above significant non-Coverys underlying layers of insurance coverage and the loss is not anticipated to pierce the Coverys layer. While the detailed attention and claim-handling expertise of a Claim Consultant is not needed for these sorts of exposures, it is nevertheless critical to monitor these sorts of losses on a periodic basis to flag any that project a potential financial exposure to Coverys for closer scrutiny.
Essential Duties & Responsibilities
Intake – respond to general claim questions/inquiries; receives, tracks and coordinates new losses
Coverage Verification - Receive new losses, confirm coverage and evaluate whether appropriate for ACC handling or whether timely referral to Claim Consultant/Specialist for handling or to management for more expert coverage evaluation is needed
Initial Set Up - Establish matter in NetCore, including reserve assessment, in accord with department policies and procedures and all required data fields
Opening letters - Send opening letters or acknowledgements appropriate to the type of event and its related policy
Correspondence Management - Receive, review and import to OnBase all correspondence on the file, follow up as needed on information and note any issues that may need the attention of a Claim Consultant/Specialist or management and refer them as needed
Data Entry – Update data in NetCore or other systems as appropriate
Documentation - Document files regarding significant events and communications in NetCore file notes
Referral - Make timely and appropriate referral of all matters necessitating handling by Claim Consultant or a member of Claim Management including documentation of reason for same
Invoice Management – Pay any non-legal invoices related to the matter
Account Management – Serve as point person for accounts, as requested
Reporting - Coordinate loss runs, bordereau reports and other reports as required
Payment - review assumed reinsurance contracts to understand Coverys' contractual obligations, cross check reimbursement requests for accuracy, and process reimbursement checks
Reinsurance - Report matters to the Coverys Reinsurance intermediary and update our reinsurers as appropriate
Audits - Organize and participate in policyholder audits, as required
Closure - Monitor NetCore based files for closure and complete closing correspondence and data fields.
Education, Requirements & Competencies
Bachelor's degree from four-year college or university, or equivalent experience.
Knowledge of medical, legal, and insurance terminology is required.
Reinsurance experience is strongly preferred.
Strong written and oral communication skills.
Must have training in insurance contract/policy review and application.
Must be comfortable making oral presentations to staff and insureds.
Must be able to synthesize complex or diverse information; collect and research data; use intuition and experience to complement data; design workflows and procedures.
Must have the ability to design and generate creative solutions.
Broad knowledge and experience in liability insurance (medical professional liability insurance is a plus)
Excellent organizational skills and customer service skills
Above-average skills in Microsoft Word, Excel and Outlook
Demonstrated ability to multi-task and manage competing demands.
Base salary range is $70,000 - $95,000. Individual compensation packages are based on a variety of factors that are unique to each candidate including location, skill set, experience, qualifications and education.
If you're a caring and customer focused individual who enjoys working with passionate team members, Coverys is the right company for you!