Senior Claims Administrator

Job Description

TITLE:                                    Senior Claims Administrator

DEPARTMENT:                  Integra Technical Services

REPORTS TO:                      Managing Director, Americas

STATUS:                               Regular, full-time; exempt          

SUMMARY OF JOB PURPOSE 

The Senior Claims Administrator provides a broad range of administrative and clerical, along with a focus on technical, support in handling complex claims. The Senior Claims Administrator will also assist the adjuster(s) in providing correct and timely client services and in assuring the insurer fulfills its obligation to policyholders. Further, the role also provides an opportunity to expand upon the incumbent’s existing understanding of the industry and the claims adjusting process and to demonstrate potential for performance in a broader capacity.

PRIMARY JOB RESPONSIBILITIES

• Assists adjusters with tracking the status of pending claims as needed. This includes communication with assisting adjusters for updates and report, as well as having an understanding of current status.
• Understands specific account requirements and communicates to the assisting adjuster(s) regarding account details and follow-up communications.
• Maintains documents in appropriate claims system(s); closes files and prepares files for storage, in keeping with established processes and procedures.
• Composes electronic and hard-copy business memos, reports, and correspondence. Proofreads documents for accuracy and compliance with any account requirements. Prepares and files electronic and hard-copy documents, using various software applications as required.
• Drafts and develops documents, including proof of loss, statements of loss, basic status reports, status update email correspondences, spreadsheets for tracking payment, etc. for review by adjuster(s).
• Enters data in time and expense system as needed.
• Maintains office files and accesses documents on behalf of adjusters, leader(s), and clients as necessary and in accordance with disclosure and confidentiality requirements. Ensures correspondence is saved to electronic file to assist with easily identifying current status.
• Research content and drafts materials for various business purposes, including, but not limited to, client presentations and marketing efforts. May prepare PowerPoint or similar electronic-format presentations and uses audio-visual equipment to facilitate presentations.
• Develops a basic knowledge of property and construction fundamentals, and/or knowledge of the specific industry or business affected to better understand property inspections and loss substantiation.
• May communicate with claimants, insureds, and experts such as architects, engineers, builders, construction workers, police officers, health care practitioners, accountants, and others to assist the adjuster in fully and accurately assessing the extent of the loss. Receives and follows up for status of payments on behalf of the adjuster(s).
• May communicate with examiners to provide current statuses, as needed.
• Develops a basic understanding of insurance policies and coverage types as a context for administrative and technical tasks performed (particularly in relation to SOVs, TIVs, deductibles, policy limits, additional loss payees, etc.)
• Assist adjuster(s) in preparing and distributing accurate, clear, thorough, and concise reports and letters to insurance carriers on conclusions and recommendations. Follows established policies, procedures, and processes in preparing information, and submits reports and documents in a timely manner and in accordance with insurer’s standards and expectations. May learn the effective use of Xactimate to produce accurate estimates.
• Assists assigned adjuster(s) with account management tasks (i.e., monitoring loss runs, following up with assisting adjusters, being an alternate point of contact for current status inquiries) as requested.
• Maintains records of claim amounts paid to date and performs follow-ups for authorization of payment status.
• Assists assigned adjuster(s) in keeping field notes, diary entries, and time and expense records up-to-date and submitted in a timely manner. Prepares reimbursement reports in keeping with organization and client policies, procedures, and practices.
• Obtains supervision of guidance as necessary, and in accordance with EM policy and practice, when setting up files or completing evaluations and reports.
• Stays abreast of office and company policies, procedures, and practices; participates in ongoing training and development as assigned or approved to assure knowledge and skills remain current and comprehensive.
• Establishes and maintains positive working relationships with other members of the organization across departments, divisions, and locations.
• Maintains the confidentiality of proprietary and sensitive information, exercising sound judgment and discretion in any disclosure of information related to EM and its endeavors.
• Upholds the values of Engle Martin & Associates and Our Foundation.
• Adheres to all applicable State Insurance Regulation requirements and other applicable laws, regulations, and standards.

REQUIRED EDUCATION & EXPERIENCE

• Bachelor’s degree in a related field, or demonstration of equivalent knowledge and critical thinking skills preferred
• 1-3 years of experience in an administrative role preferred
• At least two years of experience working in commercial property adjusting or other insurance-related work

DESIRED KNOWLEDGE, SKILLS & ABILITIES

• Basic understanding of insurance coverage and knowledge of commercial and residential construction industries
• Ability to interpret policies and other technical information
• Proficiency in a variety of office and industry software
• Reporting and formatting skills
• Detail-oriented, with the ability to research, analyze, and problem solve
• Sound written and verbal communication skills
• Excellent communication and customer service skills
• Effective time management and organization skills
• College level mathematical and accounting skills preferred
• Trustworthiness, integrity, and personal accountability and adherence to standards of ethical behavior and professional conduct
• Commitment to confidentiality and ability to discretely handle sensitive information
• Commitment to professional and personal growth and development

WORKING CONDITIONS 

Work is conducted primarily in an indoor office environment with protection from weather conditions and with exposure to noise typical of an office or administrative setting.  Position may involve both office and remote work.

PHYSICAL ACTIVITIES AND REQUIREMENTS

Lifting and carrying up to 20 lbs.; frequent standing, sitting, walking, bending, and reaching; occasional kneeling, and stooping; handling office equipment; periodic driving may be required; visual acuity to prepare, read, and organize detailed hard copy and electronic documents; ability to speak and to hear the spoken word in normal face-to-face, web-based, and telephonic business communications. Willingness to accommodate occasional meetings and work activities that may be scheduled after normal business hours.