Claims Specialist

3 weeks ago

Edmonton, Canada CMB Insurance Brokers Full time

Reporting to the VP Operations and in conjunction with the VP Sales, the Claims Specialist is responsible for developing claims programming, training and supervising claims activities at CMB. They will develop and uphold high standards for claims reporting, management and driven to train and mentor and deliver creative solutions to protect client operations.

**ESSENTIAL FUNCTIONS & RESPONSIBILITIES**
- 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
- 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 and coverage 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**
- Take all steps to avoid Errors & Omissions, and report any potential E&O to the VP Operations
- Report all potential bad debts to the VP Operations
- Be familiar with, and follow, company policies and procedures as established (Employee Handbook, Renewal Procedure, 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 and Skills**:

- 10+ years claims experience including management and litigation
- Experience with Downtime, Cargo, CGL, Cyber and large property claims
- Experience with Bodily Injury and BI claims with understanding of WCB legislation
- 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 Renewal Process, Accounts Receivable Process
- Experience in career planning and team development desirable

**Education Requirements**:

- Licensed Level 2 Insurance Agent desirable
- Completion of FCIP, CIP, CRM or CAIB designation or equivalent desirable
- **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.**_

**Job Types**: Full-time, Permanent

**Salary**: From $60,000.00 per year

**Benefits**:

- Company events
- Dental care
- Disability insurance
- Life insurance
- On-site parking
- Tuition reimbursement
- Vision care

Schedule:

- Monday to Friday

Application question(s):

- Do you have your Alberta Level 2 Insurance License?
- Do you have your FCIP, CIP, CRM or CAIB designation?

Work Location: In person

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