Senior Claims Representative, Analyst

🕒 September 15

⛰️ Colorado, Illinois, +5 more states – Remote

⛰️ Colorado – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote ❄️ Minnesota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote 🧀 Wisconsin – Remote

⏰ Full Time

🟠 Senior

📋 Claims Specialist

👻 Ghost score 18%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Society Insurance

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1915

🍽️ Food & Beverage

🏥 Healthcare

💼 Consulting

Food & Beverage • Healthcare • Consulting

Society Insurance is dedicated to providing specialized business insurance solutions tailored to the unique needs of various industries. They focus on comprehensive coverage and a commitment to risk management, ensuring that their policyholders receive the best protection for their operations. With an emphasis on personalized service, Society Insurance works closely with local independent agents to deliver the right combination of insurance products and support.

📋 Description

• Independently resolve large and significantly complex claims by investigating losses and negotiating settlements • Determine insurance coverage by examining claim forms, policies, records, and evidence; interviewing claimants, injured workers, insureds, and witnesses; reviewing police and hospital records; and consulting experts • Determine carrier liability and settle claims according to policy provisions and authority levels • Handle mediations, arbitrations, subrogation, and litigated files • Mentor and train claims representatives, shared claims staff, and interns • Provide after-hours claims emergency support when on call • Collect, analyze, and summarize claim information and recommend reserve changes and future file handling • Investigate questionable claims and compare claims information with evidence • Recommend litigation and evaluate negotiated settlement options and evidence • Manage higher-exposure and highly complex claim files • Oversee independent adjusters and attorneys to ensure company guidelines and procedures are followed • Prepare reports and ensure proper file documentation in accordance with claims guidelines and state requirements • Participate on catastrophe teams, determine department investigation guidelines, provide underwriting feedback, build agent relationships, and help select vendors • Maintain professional and technical knowledge through training and continuing education • Research state statutes, laws, regulations, case law, technical bulletins, and jurisdictional changes • Communicate changes and impacts to claims handling with Claims Managers, Senior Quality Specialists, and the Claims Director • Analyze business processes and workflows, recommend compliance improvements, and streamline processes • Collaborate with Claims leadership on training and facilitate state meetings • Troubleshoot workers' compensation vendor issues with Claims Vendor Managers and Claims Managers • Assist with state interest credit, penalties, physician panels, annual state reporting, and compliance reviews • Update state materials on the Claims Insider/SharePoint site and communicate updates to staff

🎯 Requirements

• Bachelor's degree in business or related field and 7+ years of handling complex claims OR 10+ years of claims handling experience involving discretionary decision-making and increasing levels of claims complexity • Valid driver's license and satisfactory driving record • Willingness to travel in person to mediations, agency visits, key discovery depositions, and field investigations throughout the service area when necessary • Technical proficiency in commercial property and/or casualty claims • Knowledge and experience in insurance policies and coverage, claim payment procedures, insurance regulations, and legal terminology • Ability to obtain and maintain proper licensing prior to handling a state where Society requires it • Familiarity with PC applications including word processing, Internet, spreadsheets, and email software • Ability to develop and maintain good working relationships • Professional designations of AIC, ARM, CIC, CPCU, or equivalent coursework preferred • Valid state adjuster license where required preferred • Knowledge of medical terminology preferred • Advanced knowledge of litigation processes, procedures, terminology, and legal research preferred

🏖️ Benefits

• Salary with bonus plan • Health, dental, life, and vision insurance • Traditional or Roth 401(k) Defined Contribution Plan • Profit-Sharing Plan • Company-paid holidays • Flexible scheduling • PTO • Telecommuting options • Career Coaching • Company-paid courses • Student loan and tuition reimbursement • Charitable Match • Paid volunteer time • Team sponsorships • Employee Assistance Program • Wellness initiatives/rewards • Health coaching

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