Senior Program Services Audit - Claims

Description

POSITION SUMMARY:

Perform claim audits of Trean’s partners as well the direct business of Trean’s carriers. This position will conduct both electronic and on-site audits of the claim files and processes of our partners

KEY RESPONSIBILITIES:

• •Planning and scheduling all required claims audits on assigned Programs.
• •Audits include adherence to guidelines, including accuracy, consistency, and compliance.
• •Assists in developing effective follow-up procedures, systems and management reports that will ensure Program Partners’ and/or TPA’s compliance to audit findings and recommendations.
• •Reporting of claims to reinsurers/reinsurance broker that meet reporting criteria
• •Plan and facilitate audit wrap meetings which may be virtual or in person, the latter of which will require travel.
• •Work with our partners if they have specific claim questions
• •Provides claims data and analysis to our independent actuary
• •Research industry claim issues and make recommendations to update our claims best practices
• •Representation of Trean with Industry Groups (SAWCA, WCI, etc.)
• •Perform other activities, duties and assignments as needed or requested
• •Eligible for remote or hybrid work arrangement

Requirements

MINIMUM QUALIFICATIONS:

• •Bachelor’s degree
• •Industry designations are preferred (AIC, ARM, CPCU).
• •8-12 Years of Primarily Property/ Casualty claims experience to include general liability, commercial auto/transportation/trucking. Secondary Workers’ Compenstion experience will be considered on a case-by-case basis. This experience should be as a desk adjuster with ownership of the claims decisions, documentation, reserving, vendor assignment and management, litigation oversight, reporting to carriers, reinsurers, and other stakeholders along with heading up negotiations and settlement on claims assigned.
• •Working knowledge of laws and regulations relevant to Claims standards, processes and procedures.
• •Working knowledge of claim systems
• •Working knowledge of MSOffice; Word, Excel, Powerpoint, Outlook, Teams
• •Sales Force experience is preferred.
• •Experience working with RMIS platforms
• •Experience handling large loss reserves and settlements
• •Flexible and adaptable to change.
• •Able to work independently, self-manage time, assignments and work-schedule in order to satisfy all deadlines on work assigned.
• •Must be customer focused internally and externally.
• •Interpersonal and teamwork skills are needed.
• •Must be able to manage change effectively.

CONFIDENTIAL INFORMATION:

All information (written, verbal, electronic, etc.) that an employee encounters while working at the Company is considered confidential. Reference corporate policies, guidelines and applicable laws.

WORKING CONDITIONS

This position is located in a professional office environment. This role routinely uses standard office equipment and requires the physical demands of a normal office position with some light lifting. This is a full-time position with benefits. This qualifies for remote or hybrid work. If you are a remote worker, you must be able to provide a quiet, private space in your home that enables productivity, participation in required meetings/calls and presents a professional environment to properly facilitate your work.

DISCLAIMER

This job description is not a contract of employment. It represents the minimum requirements of the job and includes the major responsibilities but not all responsibilities. Trean Corporation will change and update this job description, as necessary.

Any employment with Trean Corporation will be “at will,” meaning that either you or the Company may terminate your employment at any time and for any reason, with or without cause or advance notice.