Job ID: 24-16772 Type: Regular Full-Time # of Openings: 1 Category: Insurance & Administration Mitchell International, Inc.
Overview
The Enlyte Family of Businesses
Mitchell | Genex | Coventry
Enlyte is the parent brand of Mitchell, Genex and Coventry, an organization unlike any other in the Property & Casualty industry, bringing together three great businesses with a shared vision of using technology innovation, clinical services and network solutions to help our customers and the people they serve. Our suite of products and services enable our employees to help people recover from challenging life events, while providing opportunities for meaningful impact and career growth.
Responsibilities
Senior Claims Analyst 3 investigates, evaluates, disposes of and settles claims with minimal supervision, including the investigation, determination and evaluation of coverage, compensability/liability and damages, and the setting of proper reserves in accordance with legal statutes, policy provisions and company guidelines.
Perks: Full and comprehensive benefits programs starting on your first day, 24 days of paid vacation/holidays in your first year plus sick days, Employee Assistance and a Referral Program.
Responsibilities include
The Specialist is expected to act as a Senior Claims Adjuster Specialist carrying a reduced pending while also performing supervisory functions.
Assistant Supervisor is expected to plan, direct, and guide the activities of adjusters.
The Senior Claims Analyst 3 is expected to assist Supervisor with tasks as assigned which could include Supervision of files, performing monthly SCORE audits, Internal claim reviews, performing 1:1 performance meeting with staff, New claim set up and documentation, Review and approve reserves, Training, Attend client meetings.
Specialist will meet with the Supervisor regularly to discuss any concerns or issues.
Specialist may assist in hiring and training of new employees.
Understand concepts of coverage, policy interpretation, exposure recognition and liability determination to analyze and move claims toward resolution using Best Practices.
Promptly investigate all assigned claims for coverage, liability assessment and damages.
Investigate claims by interviewing claimants and witnesses, establish claim reserves, handle evidence, obtain evidence, obtain and interpret official reports, medical reports and claim forms, and attend/participate at mediation, trials or hearings.
Negotiate and settle claims, set reserves and manage litigation within client service parameters and authority levels by obtaining demands and making offers to claimants.
Attending client meetings and present PARs.
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 in mediation, trials, or hearings.
Routinely interact with clients, claimants, attorneys, investigators, experts, and other vendors.
Qualifications
Minimum Education: Associate or bachelor’s degree
Required Skills and experience:
At least 5-6 years of experience handling liability claims required.
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.
Ability to multitask; excellent negotiation skills.
Superior organizational and decision making skills.
Customer-focused
Strong analytical and strategizing skills;
Significant understanding of self-insured retention, excess and reinsurance reporting; fluent in medical terminology and medical/injury treatments.
