Claims Advocate

JOB TITLE: Claims Advocate

REPORTS TO: Director of Consulting Client Services

EXEMPT/NON-EXEMPT: Exempt

DIVISION: Horton Consulting Services

GENERAL DESCRIPTION – Summary

The Claims Advocate will perform claim consultation and client advocacy on behalf of our clients. They will provide a high-level claim consulting to include review and trend of client claims. Independently provides technical services within a specialized function in direct support of Sales & Service teams. Typical years of experience will vary based on specialization.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:

• Provide technical services within a specialized function in direct support of Sales & Service teams
• Collaborate within self-managed team for efficient objectives, processes and procedures through continuous improvement efforts
• Oversee claim assignments, services and onboarding to implement procedures for clients
• Provide claim consultation and client advocacy for assigned producer’s clients
• Coordinate, facilitate, prepare and attend all scheduled client claim reviews
• Identify, organize and execute client claim review meeting agenda
• Collaborate with carriers/tpa to develop appropriate claims action plans and target dates. Ensure carrier/tpa follows through on plans
• Prepare unit stat reviews for Special Service Clients
• Evaluate large files for settlement value and appropriate reserves. Discuss with carrier/tpa to ensure claim is appropriately reserved
• Track complicated claims for resolution plans and closure
• Document clearly and concisely all relevant activity on assigned files and makes recommendations for additional activity as appropriate
• Assist and participate in prospecting. Attend prospect calls or meetings as requested
• Provide specialized claim service as requested
• Act as a resource for clients in resolving their claim concerns
• Assist in interviewing and hiring
• Coordinates with Carrier Claim Liaison to ensure quality claim service
• Collaborate as team to coordinate effective participation in claim meetings
• Facilitate claim training to ensure all claims team members continue to grow their claims knowledge and meet the claims needs of our clients
• Troubleshooting of coverage problems as well as other types of declinations
• Train intradepartmental staff on effective internal claim management procedures
• Other duties as assigned

KNOWLEDGE, SKILLS, AND ABILITIES

• A Bachelor’s Degree is required
• Property and Casualty License must be obtained within 75 days of the first day of New Hire Onboarding
• Commitment to advancing your insurance knowledge via training and obtaining approved industry designation
• Associate in Claims (AIC)
• 4 years claims experience and have strong commercial lines coverage knowledge. Must understand all forms of coverage.

BEHAVIOR STANDARD

Maintain a positive work atmosphere by acting and communicating in a manner so that you get along with customers, clients, co-workers and management. All employees are expected to behave in a manner consistent with the corporate values outlined as Driven, Excellent and Together.

PHYSICAL REQUIREMENTS

Ability to:

· Perform work on a computer for extended periods of time

· Sit/stand for extended periods of time in work area

· Grasp objects using your fingers (fine motor skills)

· Communicate and speak in a clear, concise and professional manner both in person and on the telephone.

· Travel by air or ground transportation as required in performing job duties.

· Be able to lift and carry objects that weigh a minimum of 40 pounds

Nothing in this job description or in any other written documents or forms maintained by The Horton Group, creates, or may be deemed to create, an employment contract between The Horton Group and any of its employees.

The Horton Group reserves the right to revise the contents of this job description, at any time, without prior notice to its employees.

This job description supersedes any previous oral or written job descriptions.