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Senior Claims Advocate

4 weeks ago

Greater Edmonton Metropolitan Area, Canada Insurance Growth Network Full time

Reporting to the Claims Specialist, the Senior Claims Advocate is responsible for reporting all claims on behalf of the CMB Insurance Brokers brand as well as internal and external investigation of all losses to determine liability and to coordinate the management of all claims arising from losses.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES

  • Guide our clients through the evaluation and total loss process.
  • Assist clients with the dispute resolution process.
  • Guide our clients through claims that they would like to handle themselves.
  • Assist our clients with the understanding and completion of a final release when looking after losses outside of insurance.
  • Review and advise on claims service reports, trends and KPIs
  • Assist with specialized claims defense programs (Slip & Fall, Incident RPTS) for clients
  • Assist with claims training development and facilitations
  • Report claims to insurance companies when report received from clients or client representatives
  • Communicate effectively with clients regarding ongoing claims and claims process
  • Create claims file and track claim progress utilizing systems in use by CMB Insurance Brokers
  • Ensure that claims files are maintained on the CMB Insurance Brokers systems (TAM)
  • Follow up on open claims with all parties to facilitate the closing of the claim, work with the sales & service teams to establish a course of action when necessary
  • Mediate claims on behalf of clients when necessary
  • Coordinate emergency response teams, first report of incident and the setting up claims files
  • Establish and maintain working relationships with insurer claims departments in order to facilitate open claims
  • Establish and maintain a working relationship with independent adjusting firms and vendors

CLAIMS ADMINISTRATION

  • Review policy wording, coverage, Insurance Act & Tort Law as it applies to claims for CMB clients
  • Review and document recommendations for claim disposition, including evaluation, negotiation and settlement of claims.
  • Provide oversight and guidance for claims administration for US and Canadian incidents
  • Work with the Risk Management department to establish and monitor claims reserves on large accounts to ensure adequate funding levels are maintained and aggregate limits are not breached
  • Obtain quarterly reports from all insurers to prepare and distribute quarterly ageing reports, reserve adjustments, and loss ratios
  • Establish and maintain performance metrics to demonstrate efficiencies of the department, such as number of claims compared to total claims cost year over year, claims loss development year over year, average time taken to open and close claims year over year.
  • Monthly Reporting as attached & Other duties to be determined

TEAM SUPPORT

  • Mentor junior staff with technical knowledge
  • Take all steps to avoid Errors & Omissions, and report any potential E&O to the Claims Specialist
  • Report all potential bad debts to the Claims Specialist
  • Be familiar with, and follow, company policies and procedures as established (Employee Handbook, Claims Procedures, Collections and AR Procedures, etc)
  • Attend and participate in staff meetings and company functions

REPORTING REQUIREMENTS

  • Monthly reporting
  • Total Claims by Agent, by Department, by Age of Claim
  • Average Close time by Type of Claim
  • Open Claims by Customer, by type of loss, by insurance company: All sorted by department
  • New Claims by Customer, by type of loss, by insurance company: All sorted by department
  • Closed Claims by Customer, by type of loss, by insurance company: All sorted by department

Knowledge, Skills & Experience:

  • 5-10 years claims experience including supervisory skills
  • Experience with Downtime, Cargo, CGL, Cyber and large property claims
  • Understanding of WCB legislation, Injury and Accident Benefits, and BO would be an asset.
  • Understanding of litigation options under Tort Law
  • Experience with Quantum and Liability negotiations, and investigations
  • Experience with The Agency Manager, Policy Works, Microsoft Office Suite or comparable computer systems
  • Experience with the accounts receivable process would be an asset
  • Experience in career planning and team development desirable
  • Creative problem solving skills

This job operates in a professional office environment. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.