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 d... more details
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:
Claim documentation
Respond timely to incoming claims and monitor ongoing
Claim investigation as needed
Telephone and on-site investigation
Employee and customer interviews
Referrals to outside vendors
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
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
Authority requests are presented to the Director of Risk Management
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
When a claim is sent to our Attorney, same duties as above apply
Follow instructions communicated to pass on to defense attorney
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
Store Openings
Set up of Sweep Trax for new stores
WEEKLY JOB DUTIES:
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
Store Inspections
Store visits will be done as instructed by the Director of Risk Management
Inspect for adverse liability conditions and/or store operations
Report to manager my findings and discuss a solution
Report to manager if a sweep compliance is unacceptable
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
Insurance Certificate Program
Maintain up to date our Insurance Certificate Program
Insurance certificates from vendors and contractors as needed.
Requests are made as needed
New Vendor Application process
Insurance Needs
Handle any General Liability Auto, and Property insurance needs
Add new vehicles as instructed
Add new stores as instructed
MONTHLY JOB DUTIES:
Claims
Generate monthly reports, regarding frequency and location of customer claims
Analyze report; recommend preventative measures share with store management
Review monthly billing and present to Director of Risk Management timely
Check figures, claims, etc. ensuring reimbursement is appropriate
Perform monthly store inspections as needed
QUARTERLY JOB DUTIES:
Claims
Quarter end reports (same as monthly)
YEARLY JOB DUTIES:
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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