Program Claim Specialist
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Job Description
Program claims specialist overseeing TPAs, litigation, and complex liability claims for TruStage. Managing claim strategies, audits, relationships, and cross-functional insurance operations.
Responsibilities:
- Oversee assigned Program Third Party Administrators (TPAs)
- Handle new and existing litigation claims, including complex professional and general liability litigated claims
- Serve as primary point of contact and relationship manager for program claims
- Investigate, evaluate, negotiate, and resolve assigned claims
- Coordinate operational and leadership responsibilities to ensure consistent claim results, quality, and customer service
- Develop claim protocols, strategies, and handling authority; provide education and training
- Collaborate with business partners to vet and onboard new programs and TPAs
- Monitor and improve communication of essential claim information and monthly data collection
- Collaborate with Underwriting, Actuarial, Product, Finance, and Treasury on program business
- Conduct in-person or remote claim file reviews and audits across multiple TPA claim systems
- Travel to program managers, brokers, reinsurance intermediaries, TPAs, clients, industry meetings, and conferences as required
- Identify emerging claim trends
- Monitor and document claim processes and guidelines; implement process improvements
- Participate in Claim organization strategy initiatives and projects
- Collaborate with Claim Operations leaders on selecting and managing TPAs and outside vendors
Requirements:
- Bachelor’s Degree in Business Administration, Insurance, Finance, Economics, or related field of study is strongly preferred
- 7+ years of P&C Insurance claims experience
- Adjuster license and continuing education as needed
- Ability to communicate clearly and effectively with internal and external clients remotely or in person
- Strong critical thinking and analytical skills
- Progressively senior claim roles with strong technical skills
- Experience with Property and Casualty lines including Property, General Liability, Automobile Liability and Physical Damage Liability, and Professional Liability
- Strong interpersonal and consultative skills
- Creativity, flexibility, emotional intelligence, adaptability, and problem-solving skills
- Ability to manage and develop industry relationships with Program Managers, Brokers, and Reinsurance partners
- Ability to travel approximately 10%
- CPCU, AIC, ASLI, or other industry designations or certifications are highly desirable
Benefits:
- Annual incentive (bonus) plan may be available
- Medical insurance
- Dental insurance
- Vision insurance
- Employee assistance program
- Life insurance
- Disability plans
- Parental leave
- Paid time off
- 401k
- Tuition reimbursement
- Flexible workplace and work-life balance
- Career growth
- Retirement assistance
- Flexibility to work in a preferred location
- Technology and other tools supporting hybrid working
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