Claims Advocate

Job Purpose:

Develop and maintain client relationships through advocacy on claims and related issues. Perform claim reviews to ensure reserves are adequately set, claims files are moving toward closure, and communicate with client and claims professionals on a regular basis to achieve meaningful results.

 Responsibilities include but are not limited to the following:

  • Develop and maintain relationships with clients and internal team members to provide effective handling of claims.
    • Maintain client loss/claims files within agency management system, and provide updates as needed or agreed upon with Client Executives and clients.  Access carrier websites as needed to ensure proper documentation.
      • RMCM Activity (Identified Clients) – Create strategy and provide guidance to identified agency clients in a coordinated effort with Risk Manager
      • Respond with timely claims intake and subsequent timely follow up with client until closure
      • Inform agency management with regards to any new claims or reserve changes greater than $25,000.
      • Work with appropriate personnel, both internal and external, to review all disputed or denied claims.
    • Strategic communication with clients regarding claims related topics, i.e. return to work, billing, claim status, litigation, safety, amongst others.
    • Communicate with Client Executives regarding claims and other issues, developing a strategy to work and resolve issues on behalf of client.
    • Ability to negotiate with adjusters on behalf of clients to have positive outcomes related to claims, including the filing of new unit stat cards as necessary.
    • Ability to negotiate/sell claims services to prospects at Client Executive sales meetings.
    • Provide backup support to Claims Administrator role
    • Provide afterhours phone support as needed
    • Obtain and analyze loss run reports for identified carriers of the agency and provide quarterly update to management with regards to open claims.

    Assist in business development

    • Participate in occasional sales and service meetings at the request of Client Executives and clients.
    • Keep abreast of the industry through independent study, seminars and community resources.
    • Provide written communication to associates and clients in reference to key occurrences within the industry. This is done through articles, emails, etc.

 Skills/Qualifications:

  • Excellent verbal and written communication skills.
  • PC, Microsoft Outlook, Word, Excel experience required (Office 2010 preferred).
  • Familiar with standard concepts, practices, and procedures within insurance.
  • Experience with Applied Systems EPIC management system (preferred but not necessary).
  • Works under general supervision.
  • A certain degree of creativity and latitude is required.
  • A positive, “can do” attitude with an undaunted curiosity to learn more and consistently improve

Online Application

Please upload your cover letter & resume. If there are issues with the upload, please e-mail to info@avidrisk.com.
  • Accepted file types: doc, docx, pdf.
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