Primary Details
Time Type: Full time
Worker Type: Employee
Claims Specialist - Accident and Health
- Location: USA - MA - Marblehead
- Work Arrangement: Hybrid
- The salary range for this role is: $75,000 - $128,000
The Opportunity
Manage a portfolio of moderately complex claims by conducting loss investigations, evaluations, and settlements on moderate to high-level claims for assigned lines of business. Ensure timely and accurate reserves. Collaborate effectively with Underwriting, Actuary, Legal, and Risk teams. Conduct and coordinate loss investigations within authority limits to provide accurate facts for disposition.
Your New Role
- Administer insurance coverage to moderately complex claims through loss investigations, analyzing factual data, interpreting policies, and applying legal and technical knowledge for timely resolution.
- Negotiate claims settlements by collaborating with experts and involved parties, recommending reserve modifications, and communicating solutions to mitigate risks and coverage conflicts.
- Inform stakeholders about claims resolution processes by summarizing factual information and managing documentation to ensure clarity on individual claims.
- Build strong relationships by reporting on claims strategies, fostering understanding of Claims operations, and promoting collaboration.
- Support workflow efficiency by documenting progress, referring high-risk exposures outside authority, and seeking operational improvements.
- Contribute to a positive work environment by demonstrating cultural values, encouraging accountability, diversity, inclusion, flexibility, continuous improvement, collaboration, creativity, and fun.
Required Education
Bachelor's Degree or equivalent experience.
Required Experience
Minimum of 3 years relevant experience.
Required Licenses/Certifications
Obtain and maintain state adjusting licenses as needed.
Preferred Competencies/Skills
- Effective communication to influence decision makers.
- Conflict mediation and resolution skills.
- Ability to analyze relevant information and assess impact.
- Maintain integrity of claims data and evidence.
- Utilize multiple resources for data analysis.
- Leverage technical knowledge for cost-effective decisions.
- Encourage open communication and knowledge sharing.
- High attention to detail.
- Strong planning, prioritization, and organizational skills.
Preferred Experience
- Experience in claims department or insurance industry.
- Knowledge of contract interpretation and negotiation.
- Experience in brokerages, third-party administration, risk management, or legal roles.
Preferred Knowledge
- Claims administration best practices.
- Insurance products and services.
- Relevant laws and regulations across jurisdictions.
- Market trends and organizational strategies.
- Proficiency in Microsoft Office and database systems.
Compensation Package
The salary range is as specified. Offers depend on role complexity, location, and candidate background. Employees are eligible for an annual discretionary bonus based on performance.
Benefits
- Hybrid work model (home and office).
- 22 weeks paid family leave, gender-equal.
- Competitive 401(k) with up to 8% match.
- Well-being programs including guided meditations and rebates for fitness.
- Tuition reimbursement for continuing education and certifications.
Why QBE?
We aim to build a resilient future for customers, communities, the environment, and our people. Join us to work with passionate, talented individuals and make a meaningful impact.
Learn more: QBE LinkedIn
Commitment to Diversity
We foster an inclusive workplace where everyone is valued. Assistance during recruitment is available upon request.
Equal Employment Opportunity
QBE is committed to equal opportunity employment and complies with applicable legislation.
Skills
Analytical Thinking, Business Process Improvements, Claims Settlement, Critical Thinking, Customer Service, Insurance Analysis, Insurance Claims Management, Insurance Policies, Collaboration, Managing Performance, Negotiation, Problem Solving, Risk Management, Sound Judgment, Stakeholder Management
How to Apply
Click "Apply" and follow the steps to submit your application.
