Claims Specialist
MMC

Job Info

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SUMMARY:

As a Claims Specialist for the Marsh McLennan Agency, you will be a claims consultant providing oversight and advocacy on behalf of our clients throughout the process of a loss event and the life of a claim. This position is client facing and requires single-day regional travel to our client locations.

Duties include:

• You will submit claims or provide guidance on claim submission;
• Compiles Risk Services Plans (RSPs);
• Monitors RSPs to ensure we are delivering all services as promised;
• Review coverages and resolve claims issues;
• Compiles & delivers Stewardship Reports to clients;
• Compiles e-mod forecasts & delivers e-mod analytical reports;
• Assists clients in finding solutions for problematic modifiers;
• Reports claims to insurance carriers, assisting in the communication between clients and adjusters;
• Ensure carrier commitments are honored;
• Coordinate and participate in scheduled claims reviews;
• Serve as your client's advocate with adjusters and their coverage counsel;
• Resolve coverage disputes whenever possible;
• Assess and strategize to produce best possible claim outcomes;

Duties may also include:

• Review of client's overall claims program and individual complex claims situations;
• On-site visit when a catastrophic loss occurs;
• Completes Open Claims Reviews
• Develop strategic action plans to reach desired outcomes;
• Provide guidance regarding potential large settlements;
• Recommend suitable vendor partners, including claims TPAs, nurse triage, and others;
• Review adjuster's claim action plans; facilitate claims resolutions;
• Evaluate insurance company claim reserves and push for reductions where appropriate;

REQUIREMENTS:

• High School Diploma, Bachelor's degree preferred;

• Adjusters license;
• Knowledge of accepted industry standards and practices;

• Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges;
• Analytical skill necessary to make decisions and resolve issues inherent in handling of claims;

We embrace a culture that celebrates and promotes the many backgrounds, heritages and perspectives of our colleagues and clients. Marsh & McLennan Agency offers competitive salaries and comprehensive benefits and programs including: health and welfare, tuition assistance, 401K, employee assistance program, career mobility, employee network groups, volunteer opportunities, and other programs. For more information about our company, please visit us at: http://marshmma.com/careers.

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