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Claims Advocate

Insurance Office of America
Mesa, AZ Full Time
POSTED ON 12/30/2021 CLOSED ON 1/13/2022

What are the responsibilities and job description for the Claims Advocate position at Insurance Office of America?

We’re Insurance Office of America, one of the nation’s largest privately held agencies. IOA was founded in 1988 with the idea that professional client service provided by knowledgeable, caring, and passionate people makes for a winning combination.  Whether working at our home office in suburban Orlando, Florida, one of our branch offices across the US and Northern Ireland, or with one of our subsidiary companies, the continued growth of our nearly 1,300 employees is a testament to our belief that great things start with great people!

At IOA, we’re driven by our mission and core values. We work hard, but we have fun too. Workplace ideals like leading by serving, work/family life balance, and giving back to our community aren’t just clichés here – they’re a part of who we are. We believe in helping people grow, develop and achieve their professional goals, so when you join the IOA team you truly become a partner in our shared success.

Job Summary

Responsible for IOA insurance Claims Management activities including:  Client advocacy, service and communication; problem claim resolution; data analysis/action; monitoring triggered activities; claims reviews/audits; work comp claim monitoring and resolution; reserve analysis; unit stat and stewardship reporting; client education/consulting; sales support; litigation process management; new client onboarding; Intake process support; team leadership; individual productivity, quality, and service levels; data management/entry; Producer communication;  team and individual professional development; identification of sales opportunities; IOA core values.

 

Key Responsibilities

  • Lives and champions IOA core values at all times, demonstrating the highest levels of personal character, integrity, and servant leadership.
  • Meets all performance requirements regarding production, quality, and service.
  • Delivers outstanding client service at all times, including proactively anticipating client needs, maintaining frequent and professional client communication, and responding quickly to any service requests.
  • Serves as a client advocate, continually providing high levels of ongoing client support while identifying and implementing actions in the best interest of clients.
  • Provides leadership to claims team, demonstrating a strong work ethic, positive attitude, and willingness to assist others at all times.
  • Exercises discretion and independent judgment to ensure beneficial outcomes for clients and IOA.
  • Actively seeks to grow IOA business, including identifying and acting on sales opportunities.
  • Aggressively manages any problem claims to ensure timely resolution and optimize outcomes.
  • Regularly reviews aggravated inequity loss reports and takes appropriate action on findings.
  • Monitors triggered activities on an ongoing basis, and identifies and executes appropriate courses of action to ensure resolution.
  • Conducts/participates in claims reviews and performs claims audits as required.
  • Monitors workers compensation claims via the IOA Claims Portal and identifies/takes appropriate action to drive them to closure.
  • Performs reserve analysis to ensure accurate and timely case reserves in keeping with claims best practices.
  • Prepares and delivers unit stat reporting.
  • Develops and maintains positive relationships and communication with carriers necessary to effectively negotiate and influence positive claim outcomes on behalf of clients.
  • Serves as intermediary between clients and carriers, working to facilitate mutually beneficial claims resolutions.
  • Provides ongoing internal and external client education regarding any statute changes and state specific claims procedures best practices, including claim reporting, claim investigation, return to work, and continued claims handling.
  • Develops and maintains a comprehensive knowledge of all Risk Services offerings including RiskScore®, and provides consultation on and markets those offerings to internal/external customers.
  • Identifies claims trends, makes client recommendations to promote safe work environments and mitigate exposures, and collaborates with Risk Advocates to address any identified client training needs.
  • Supports Producer presentations and sales.
  • Develops and delivers stewardship reporting in keeping with departmental standards and within required timeframes.
  • Provides claims intake process support as needed.
  • Identifies and works with clients and carriers to execute appropriate claims strategies and solutions.
  • Works with carrier claims teams to establish expectations regarding claims handling process quality, and continually monitors performance to ensure those standards are consistently met.
  • Provides timely and accurate client communication regarding claim status.
  • Participates in new client onboarding processes as needed.
  • Maintains agency operating software system to ensure accuracy and currency of data.
  • Acts as back-up for teammates as needed, covering for others in their absence and ensuring overall team service excellence.
  • Constantly looks for, recommends, and implements process improvements and best practices to improve individual, team, and organizational effectiveness.
  • Serves as claims management subject matter expert for team, answering questions, providing support, and developing solutions to client problems.
  • Monitors Individual performance to ensure productivity, efficiency, quality, and service standards are met, taking corrective actions when required.
  • Assists with initial/new hire and ongoing training support within team.
  • Encourages and participates in ongoing growth and professional development of all personnel within team.
  • Actively promotes IOA culture and a positive work environment at all times, including participation in team building and other activities.
  • Maintains frequent and transparent communication regarding individual performance and activities with supervisor, and seeks, accepts, and implements performance coaching.
  • Works effectively with Producers, seeking input and developing win-win solutions to any claims related process, service, quality, or productivity issues.
  • Complies with all company work rules, standards, and policies and procedures at all times.
  • Maintains high degree of technical competence and industry/market expertise.
  • Ensures professional skills are continuously improved by actively participating in internal/external development opportunities.
  • Develops and maintains positive, productive relationships with IOA leadership, peers, co-workers, teammates, and employees.
  • Performs other duties as assigned.

 

 

Required Competencies, Skills, & Experience

  • 5 years of claims handling experience
  • Licensed Insurance Adjuster
  • Exceptional customer service skills
  • Excellent multi-tasking, organizational, delegation and decision-making skills
  • Outstanding verbal/written communication skills
  • Ability to perform large work volumes with high degrees of accuracy
  • PC proficiency
  • Exceptional personal character
  • High School Diploma (or equivalent)
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