Senior Commercial Lines Claim Advocate

Education

• Bachelor’s degree in business; insurance; risk management; or a related field is preferred.
• Equivalent work experience may substitute for formal education in some cases.

Experience

• Extensive experience in commercial lines insurance claims handling or advocacy, 10+ years.
• In-depth knowledge of different types of commercial lines policies, including general liability, property, workers' compensation, auto, professional liability (EPL, E&O, D&O), Cyber.

Licenses/Certifications

·       Insurance Brokers and/or Adjuster’s License is a plus

·       Professional certifications such as CPCU, AIC, ARM, or CIC

Skills and Competencies

• Technical Expertise: In-depth understanding of commercial insurance policy language; claims processes; and applicable laws/regulations.
• Negotiation Skills: Ability to advocate effectively for clients during claims disputes or settlements.
• Problem-Solving: Strong analytical and investigative skills to determine the root cause of claims and resolve complex issues.
• Communication Skills: Excellent verbal and written communication for interactions with clients, insurers, and legal teams.
• Customer Service: Client-focused mindset to support policyholders through challenging claims situations.
• Technology Proficiency: Familiarity with claims management software (AMS360) and standard office tools (Outlook; Word; Excel; Adobe; etc.)

Additional Traits

• Attention to Detail: Ensures thorough analysis and proper documentation of claims.
• Time Management: Capability to manage multiple claims and priorities under tight deadlines.

Duties Overview:

• Managing complex claims for commercial insurance clients.
• Acting as a liaison between clients and insurance carriers to facilitate claim resolutions.
• Interpreting policy language and coverage for clients.
• Advising clients on best practices for loss prevention and claim management.

#LI-TM1

Our client is currently looking for a Senior Claims Specialist experience working for a retail agency with a high level of understanding the entire claims process.

Knowledge of the EPIC agency management system is a must.

Responsibilities for claims position Include:

• Report Commercial Lines and Personal Lines claims to carrier.
• Help gather and review Loss data on largest clients, to help prepare for Claims reviews.
• Work hand in hand with Claims department to ensure that all claims information is accurate in EPIC, especially on larger accounts.
• Follow up on status of claims (includes calling and/or emailing insurance adjusters).
• Guiding Insured through the claims process.
• Keep organized log of follow ups.
• Salary between $115,000-$130,000

#LI-TM1

The Senior Process, Controls & Compliance Analyst is responsible for ensuring the effectiveness and efficiency of internal processes and controls, as well as maintaining compliance with regulatory requirements. This role involves evaluating and improving business processes, identifying risks, and implementing controls to mitigate those risks. The ideal candidate will have a strong background in compliance, risk management, and process improvement within the insurance industry.

Salary/Benefits

• $75,000 - $90,000+ Year (based on experience)
• Health, Dental, Vision
• 401(k)
• PTO & Paid Holidays

Job Description

• Coordinating activities related to policy & process definition, lifecycle, adherence & review
• Conduct research and analysis in order to understand business needs and control gaps
• Lead future claims system integration efforts by applying LEAN and Agile methodologies
• Lead efforts focused on identifying, scoping, and prioritizing continuous improvement projects that align with the department's strategic plans.
• Help to introduce the required changes to processes and systems
• Ensure that they are smoothly embedded into business operations with appropriate controls

Requirements

• 5+ years of operational and/or technical experience with a focus on Compliance, Regulatory or Controls

• Experience as a business or compliance analyst at a carrier
• Track record of working with senior stakeholders
• Track record of leading smaller projects and initiatives
• Knowledge of claims processes, operating controls and operating models, or experience in a similar environment

 #LI-BC1