Job Abstract

The Senior Claims Specialist will report directly to the Director of Risk Management. Duties include overseeing and monitoring the timely response and proper handling of General Liability, Auto and Property claims on behalf of Superior Grocers. Moreover, attendance of Small Claims court matters will be ensured as required. Position will have the autonomy and authority to make settlement decisions within a pre-determined range. Responsible for timely feedback/response and providing of necessary documentation to insurance company/TPA, defense counsel and corporate office staff as instructed. Display and communicate an understanding of insurance concepts, internal practices and procedures.

DAILY JOB DUTIES:

1. Claim documentation

• Respond timely to incoming claims and monitor ongoing

1. Claim investigation as needed

• Telephone and on-site investigation
• Employee and customer interviews
• Referrals to outside vendors

1. Review and oversee new and existing customer related claims

• Accident Reports and related support documentation must be completed timely, thoroughly and objectively, thereafter provided to TPA/defense counsel/necessary parties.
• Assist with determination of liability and corresponding/appropriate defense tactics
• Ensure the timely logging of all new claims (delegate to Claims Assistant if necessary) and timely reporting to our Insurance Carrier, with guidance by the Dir of Risk Management

1. Review, oversee and manage legacy customer claims continuously and ongoing

• Utilize TPA website/database (if appl.) or internal tracking system to review the status and monitor claims being handled by outside adjusters.
• Review and approve the status of any claim, any reserve changes, and maintain communication with the adjuster handling the claim.
• Vice-Versa the adjuster can communicate with Senior Claims Specialist for added information

1. Authority requests are presented to the Director of Risk Management
2. Other Samples of requests from adjusters

• Coordinate employee recorded statements
• Coordinate internal/external investigations of incidents
• Copy and analyze video tapes
• Provide information on employees; current and terminated

1. When a claim is sent to our Attorney, same duties as above apply
2. Follow instructions communicated to pass on to defense attorney
3. Defense attorney is assigned in coordination with the Director of Risk Management

• Be prepared with monthly status report (when requested) concerning any significant changes on our position of liability or damages
• Calendar deposition appearances as necessary
• Calendar hearings as necessary
• Calendar Mediation or settlement conferences

1. Store Openings

• Set up of Sweep Trax for new stores

WEEKLY JOB DUTIES:

1. Maintain customer claim files in order

• Inspect our database in excel to make sure it is up to date and in order
• Inspect physical claims file to make sure they are up to date and in order
• Review carrier, TPA and attorney billing and update files

1. Store Inspections

• Store visits will be done as instructed by the Director of Risk Management

Inspect for adverse liability conditions and/or store operations

1. Report to manager my findings and discuss a solution
2. Report to manager if a sweep compliance is unacceptable

1. Porter Inspections

• Meet with a Store as instructed
• Review porter inspections
• Review porter schedules for each store
• Provide porter training on using scanners, the purpose for a sweep, and the need to be diligent in doing their job and in using the scanner

1. Insurance Certificate Program

• Maintain up to date our Insurance Certificate Program

1. Insurance certificates from vendors and contractors as needed.
2. Requests are made as needed
3. New Vendor Application process

1. Insurance Needs

• Handle any General Liability Auto, and Property insurance needs

1. Add new vehicles as instructed
2. Add new stores as instructed

MONTHLY JOB DUTIES:

1. Claims

• Generate monthly reports, regarding frequency and location of customer claims

1. Analyze report; recommend preventative measures share with store management

• Review monthly billing and present to Director of Risk Management timely

1. Check figures, claims, etc. ensuring reimbursement is appropriate
2. Perform monthly store inspections as needed

QUARTERLY JOB DUTIES:

1. Claims

• Quarter end reports (same as monthly)

YEARLY JOB DUTIES:

1. Assist where necessary regarding General Liability, Auto, and Property Insurance renewal

• Administrative duties only

Job Requirements:

Education:

• Bachelor Degree in business is preferred
• In addition, attend insurance seminars and insurance classes with emphasis in insurance concepts, including, premises liability and related tort applicable to the position.

Experience:

• At least 5 years work experience in the field if no Bachelor’s Degree

Knowledge:

• Working knowledge of Excel and Word.

Skills and Ability:

• Excellent verbal and written communication skills
• Ability to multi-task
• Bilingual (Spanish and English) helpful, but not mandatory

Range: $80,000 to $85,000

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