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Account Manager, Excess Property Claims Management (Client Account Support Advisor)-Qual-Lynx at Cigna

Posted in Admin - Clerical 30+ days ago.

Type: Full-Time
Location: Piscataway, New Jersey





Job Description:

Account Manager, Excess Property Claims Management (Client Account Support Advisor)

POSITION SUMMARY

Operate as the lead point of contact for any and all matters specific to clients. Equitable and accurate claims processing and settlement value in a manner consistent with client expectations and which contributes to the profitability of the company.

Location: This role will start remote than move to partial onsite in one of the following offices: Piscataway, NJ or Egg Harbor Twp, NJ

KEY RESPONSIBILITIES:


  • Understand concepts of coverage analysis, policy interpretation, exposure recognition and liability determination to analyze and move claims toward resolution using Best Practices.
  • Promptly investigate all assigned claims for coverage, damages, and financial impact.
  • Negotiate and settle claims, set reserves and manage litigation within client service parameters and authority levels by obtaining demands and making offers to insureds.
  • Manage diary and complete tasks to ensure that cases move to the best financial outcome and timely resolution.
  • Report all serious potential large loss claims to the client and/or reinsurer based upon the criteria provided by the client.
  • Document plan of action in the claim system and set appropriate diaries.
  • Manage diary and complete tasks to ensure that cases move to the best financial outcome and timely resolution.
  • Close all files as appropriate in a timely and complete manner; maintain closing ratio as directed by management team.
  • Attend/participate at mediation, trials or hearings.
  • Routinely interact with clients, claimants, attorneys, investigators, experts and other vendors.
  • Maintain a thorough knowledge of the litigation process and litigation management, an understanding of relevant jurisdictional laws and regulations, statutes and related revisions or changes in the law and apply to policies and procedures appropriately.
  • Develop and conduct first party property training for the property unit.
  • Possess a thorough understanding of first party property claims handling and catastrophic claims management.
  • Manage clients in the areas of claims administration and litigation through benchmarking, loss analysis and general performance measurement reports to ensure adherence to Best Practices, as well as company client specific claim program goals, directives, initiatives, policies and procedures.
  • Accept, review and distribute new claims as they come into department.
  • Provide guidance to staff on coverage, liability and damage analysis, especially on severe and complex claims.
  • Conduct and oversee all internal claim reviews and audits to ensure effective claims handling by adjusters.
  • Attend external client meetings to present PARs (payment authority request) and conduct claim and program reviews.
  • Conduct or participate in client training and education externally as needed.
  • In a leadership role, participate in company projects/endeavors over and above unit/client-related supervisory functions

COMPENTENCIES


  • Confidentiality - Possesses high level and regard for confidentiality.
  • Dependability - Is trustworthy, reliable and accurate.
  • Detail Oriented - Focuses on details to obtain a quality work product.
  • Follows Direction - Acts in accordance with instructions.
  • Judgment - Forms an opinion objectively and with discretion.
  • Leadership - Is able to solicit support and cooperation of others.
  • Organization - Is able to plan and carry out activities effectively.
  • Problem Solving - Evaluates information and situations, approaching and resolving in a timely manner.
  • Teamwork - Promotes cooperation and commitment within a team to achieve goals.
  • Time Management - Plans and controls time to effectively accomplish goals.
  • Work Ethic - Is hard working, diligent, reliable, and has initiative.

QUALIFICATIONS


  • Bachelor's Degree strongly preferred; HS Diploma required
  • At least 10 years of experience in the insurance/TPA industry
  • Strong leadership experience
  • At least 6 years of experience in Property & Casualty insurance experience
  • Expertise in Property and Casualty and related claims handling practices and ability to apply same
  • Must have knowledge of principles of first party property claims handling, catastrophic loss experience, and applicable state and federal laws. Must have proven expertise in vendor and litigation management.
  • Ability to work independently
  • Exceptional technical abilities
  • Proficient with MS Excel and Word; computer experience with related claims software
  • Excellent verbal and written communication skills; proven interpersonal skills capable of dealing with all levels of personnel
  • Exceptional ability to multi-task; excellent negotiation skills; superior organizational and decision making skills
  • Customer-focused orientation
  • Strong analytical and strategizing skills
  • Deep knowledge of client and carrier claims procedures; significant understanding of self-insured retention, excess and reinsurance reporting
  • Deep understanding of claims evaluations and exposure potential
  • Fluent in medical terminology and medical/injury treatments.
  • Must possess outstanding customer service skills to interact effectively with clients, defense counsel, vendors, independent adjusters, management, and subordinates.

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. What difference will you make?

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.





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