Senior Claims Adjuster - Casualty / Healthcare

Job Description - Senior Claims Adjuster - Casualty / Healthcare ()

Job Description

Senior Claims Adjuster - Casualty / Healthcare - ( )

Description

Duties and Responsibilities

• Management a portfolio of Lloyd's and Company Casualty and Healthcare claims, to include setting up new claims if necessary.
• Manage and handle claims that fall outside any Delegated Authority.
• Take ownership of policy declinatures and avoidances, not to be left with the TPAs
• Reserve in accordance with our claim's philosophy
• Negotiate and settle claims within specified authority and recommend reserves beyond authority to appropriate management as necessary
• Review and maintain your caseload (i.e. reviewing incoming claim correspondence, formulating responses, maintaining an up-to-date diary) in accordance with current internal claims procedures an comply with key performance indicators.
• Adhere to internal procedures (i.e. declinatures, large losses, complaints, fraud etc.)
• Assist with coordination of and carrying out of TPA audits if necessary.
• Carry out aged file/static claims reviews as required
• Proactively manage vendors, such as loss adjusters, TPAs defence counsel and monitoring counsel
• Demonstrate ability to drive good claims outcomes (i.e. representing AW interests at market meetings, mediations, JSMs and any other client meetings)
• Develop good relationships internally with all departments you come in contact with
• Develop an understanding of what senior management want and appropriate messaging
• Work with Underwriters to provide updates, evaluate exposures, attend client meetings where required and assist with development of policy wordings and other contractual documents where required
• Assist with the mentoring of more junior members of the Team
• Assist with Lloyd's and Company reporting requirements.
• Assist with special projects as required.

Qualifications

• University degree preferred.
• Insurance related courses or certificates are an advantage.
• Good working knowledge of the Lloyd's claims system ECF2.
• Good working knowledge of the Claims Portal.
• Good understanding of Casualty and Medical Malpractice policy wordings.
• Experience of managing bordereau and monitoring files on binder business.
• Experience of handling multi-jurisdictional claims in particular Canada, Ireland, Australia and Italy.
• Experience of managing TPAs.
• Knowledge of UK Corporate market would be beneficial.
• Working knowledge of the Microsoft Office Suite.
• Strong business writing skills.
• The ability to work well in a team environment.
• Excellent organisational skills, and the ability to work on multiple tasks concurrently