Claims Advocate

Requirements

• Gathers claim information and prepares loss notices/data entry of new claim into Epic
• Encourages and provides information for the customer to report claims directly to the carrier
• Consults with customer on the importance of prompt reporting, return to work, and risk management issues
• Assists customer with any problems that arise after the claim is reported
• Works directly with the claims adjuster to address coverage and denial issue, coordinates conference calls, as needed, and provides the customer with a resolution to the issue
• Sets appropriate Diary and provides follow up on claims from the time it is reported until it is closed
• Attaches claim information and keeps log notes updated in Epic
• Obtains information from the carrier website and from adjusters directly throughout the claims process
• Notifies all carriers involved when there is a lawsuit and notifies the Producer and/or Account Manager/Executive with any updates
• Works with claims adjusters to ensure appropriate reserve levels are set for effective resolution of claims with emphasis and focus on reserve reductions prior to client renewals
• Reviews large loss claims and works with the claims adjuster to identify possible reserve reductions
• Notifies the Producer and/or Account Manager/Executive for any significant reserve increases and keeps them updates on any catastrophic claims
• Completes Annual Claim Review Narratives timely and attends (in-person or virtually) to present to the client
• Attends (virtually) weekly hearing call meetings, monthly out of work meetings and client/carrier quarterly claim meetings deemed necessary and identified on specific accounts
• Claims consulting duties include but not limited to: Completing Audits on open claims, reviewing and making suggestions to client/carrier/TPA on Special Handling Instructions (SHI’s) other duties designated by the producers consulting contract/agreement
• Interact, communicate, and collaborate with IMA Wallingford staff; sharing information and time as needed to support business objectives
• Attends Sales and Marketing meetings as required
• Accompanies Producers and/or Account Manager/Executives on client visits, prospective clients and renewal visits
• Adheres to all policies and procedures
• Assists or completes other tasks as directed by Claims Practice Leader

Benefits

• Annual Performance Bonus
• Stock Purchase
• Medical Plans
• Prescription Drugs
• Dental
• Vision
• Family Assistance Program
• FSA
• HSA
• Pre-Tax Parking Plan
• 401(k)
• Life/AD&D
• Accident
• Critical Illness
• Hospital Indemnity
• Long Term Care
• Short-term Disability
• Long-term Disability
• Business Travel Accident
• Identity Theft
• Paid Time Off
• Flexible Work Options
• Paid Holidays
• Sabbatical
• Gift Matching
• Health Club Reimbursement
• Personal and Professional Development