Job Details

Captive Claims Advocate

Position Summary: The Captive Claims Advocate is responsible for oversight and management of claims including coordination of receiving new property and casualty first reports of claims via phone, email, fax or mail from insureds; reporting them to the appropriate carrier and following up to ensure timely and complete resolution. This position will help facilitate communication, documentation and understanding between insureds, adjusters and other involved parties in an effort to keep claims moving proactively toward resolution. Position is also responsible for assisting with education of agency employees and clients relative to claims process. Position will work with various individuals including agency, clients and carriers, claims administrators and captive personnel. Position will also work to become proficient in state regulations applicable to workers compensation benefits, along with mitigation programs offered by the various captive programs and help to educate both the insureds and producers.

Supervisory Responsibilities: None

Essential Tasks:

• Build relationships with Higginbotham Clients to help in facilitating management of their claims
• Manage a diary of assigned claims to be monitored for proactive handling.
• Tactfully communicate with assigned adjusters to maintain proactive momentum in assigned claims.
• Maintain familiarity with State specific regulation governing worker's compensation benefits.
• Research and become familiar with mitigation programs offered by the various captive programs to help mitigate worker's compensation claims.
• Actively educate insured's on both State specific regulation and mitigation programs offered by the various captive programs while assisting them to implement both.
• Prepare and provide claim tracking information
• Develop and implement innovative claims resolution processes
• Assist HIG clients with disputed claims resolutions
• Identify areas on processes to eliminate potential E&O claims
• Review claims that are declined to identify E&O exposure
• Coordination of claims management process to improve customer satisfaction
• Participate in claims review process with producers, clients and service department personnel.
• Provide education of the claims process to agency and client personnel
• Manage claim information and review reporting process in Applied EPIC claims system
• Receive and review new document claim information; manage notification process
• Suspend information and follow up with adjuster to ensure claims has been assigned and is being resolved in a timely manner
• Follow up with adjuster and insured to ensure timely resolution of claim and excellent customer service
• Continually search for process improvements and/or enhancements to workflow; make recommendations for change where appropriate
• Review documents issued by insurance company for accuracy
• Respond to client and company requests for action and information on any claims-related matter

Core Competencies:

• Ability to Analyze and Solve Problems : Skill in recognizing challenges, exploring options, and implementing effective solutions in a timely manner
• Attention to Detail : A strong focus on completing tasks and projects accurately and thoroughly
• Communication Skills : Capable of expressing ideas clearly in both verbal and written forms and engaging with various audiences
• Timely Task Completion : Ability to finish tasks and projects efficiently, managing resources and priorities effectively
• Team Collaboration : Willingness to work together with others, promoting teamwork and supporting shared goals
• Client Focus : Dedication to understanding and addressing the needs of clients and stakeholders to ensure their satisfaction
• Dependability : Acknowledgment of the importance of being present and punctual.
• Creative Thinking : Openness to suggesting new ideas and methods to improve processes and outcome
• Organizational Skills : Capability to prioritize tasks and manage multiple projects simultaneously
• Adaptability : Willingness to adjust to changing situations and priorities, showing resilience in a dynamic work environment

Experience and Education:

• High School Diploma is required
• Bachelor's degree is preferred
• Experience handling worker's compensation claims required
• 3+ years of experience in Property & Casualty Claims in a commercial insurance environment
• Experience in Claims Management process
• Knowledge of Property & Casualty forms and coverages for proper claims reporting
• Strong communication skills, both verbal and written required

Licensing and Credentials:

• Must have appropriate state insurance license (Adjuster's license preferred)

Systems:

• Proficient with Microsoft Excel, Word, PowerPoint, and Outlook
• Applied Epic experience preferred, but knowledge of similar Account Management System (AMS) is acceptable

Physical Requirements:

• Ability to lift 25 pounds
• Repeated use of sight to read documents and computer screens
• Repeated use of hearing and speech to communicate on telephone and in person
• Repetitive hand movements, such as keyboarding, writing, 10-key
• Walking, bending, sitting, reaching and stretching in all directions

Perks & Benefits:

• Generous employee benefits package which includes a robust wellness program
• Employee Ownership Opportunities
• Career progression opportunity the potential for growth within the company

Notice to Recruiters and Staffing Agencies: To protect the interests of all parties, Higginbotham Insurance Agency, Inc., and our partners, will not accept unsolicited potential placements from any source other than directly from the candidate or a vendor partner under MSA with Higginbotham. Please do not contact or send unsolicited potential placements to our team members.

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.