POSITION TITLE: Claims Advocate

REPORTS TO: Team Leader/Manager

DEPARTMENT: Claims

CONTACTS
Internal

• Manager Claims
• Claims
• Account Executives                  
• Accounts                                 
• IT

External

• Insurers                       
• Clients                                     
• Adjusters                                              

POSITION SUMMARY:
Provides support to the Claims Department in relation to incoming claims from corporate clients to bring about favourable and fair conclusion of claims, ensuring that exceptional quality customer service is upheld.

KEY DUTIES AND RESPONSIBILITIES:
Administrative

1. Reviews new claims and identify the perils covered under the pertinent policy and advise the client of the scope of coverage and limitations.
2. Assists clients in completing and presenting claims to minimize errors ensuring efficient, accurate and adequate completion of documentation and processing.
3. Thoroughly reviews the documents presented by the client and advises of any outstanding documents required for claim to be processed efficiently.
4. Notifies insurers immediately to facilitate prompt initiation of investigations, appointment of specialists.
5. Opens electronic (on EGlobal) and physical file and diarizes on EGlobal to improve efficiency of monitoring and reporting on all claims assigned to the group.
6. Follows up claim progress with insurers, clients and adjusters to keep abreast of the progress and minimize delays in settlement.
7. Provides clients and other stakeholders with timely feedback as the matter progresses.
8. Updates notes and reserves on EGlobal and on physical files in a timely manner to ensure correct and up to date information always readily available in relation to all claims assigned to the group.
9. Receives settlement cheque and remits to client within two (2) days to satisfy client requirements.
10. Updates settlement on database and closes files to facilitate accurate reporting.
11. Reviews outstanding claims on database.
12. Provides typing and clerical services to ensure prompt dispatch of correspondence to client and insurers all  claims assigned to the group.

Technical

1. Reviews policy wording in depth to thoroughly advise our corporate clients on policy coverage, conditions and exclusions in matters.
2. Attend site visits with Adjusters on claims when needed.
3. Assists the Team Leader to prepare for and conduct meetings with all stakeholders when necessary. 

Reporting

1. Assists the Team Leader to complete thorough monthly reports for clients for all outstanding claims.
2. Prepares accurate loss ratio reports or other claims reports required by the Team Lead/ Claims Manger/ Account Executive or client.

Customer Service

1. Provides exceptional customer service to both internal and external customers at all times.

 
N.B. May be required to perform additional duties of a similar nature from time to time.

EDUCATION, TRAINING, KNOWLEDGE & EXPERIENCE

1. Certificate in Insurance Practice/ Degree in relevant field
2. Sound Knowledge of the Elements of Insurance
3. Minimum of two (2) years working experience in insurance claims.
4. Good communication skills
5. Supervisory Management skills (will be an asset)
6. Good interpersonal skills

COMPETENCIES REQUIRED

1. Interpersonal Awareness: The ability to notice, interpret, and anticipate others' concerns and feelings, and to communicate this awareness empathetically to others
2. Written and Oral Communication: The ability to communicate technical information to non-technical persons on paper and verbally
3. Thoroughness:  Ensuring that one's own and others' work and information are complete and accurate; carefully preparing for meetings and presentations; following up with others to ensure that agreements and commitments have been fulfilled
4. Customer Service Orientation:  Demonstrating concern for the satisfaction of the needs of both internal and external customers.
5. Developing Others: The ability to delegate responsibility and to work with others and coach them to develop their capabilities
6. Initiative: Identifying what needs to be done and doing it before being asked or before the situation requires it.
7. Organizing, Planning, and Prioritizing Work: Developing specific goals and plans to prioritize, organize, and accomplish your work.
8. Time Management: Manage one's own time and the time of others to complete all tasks up to performance standards and within the required time frame.
9. Team Orientation: Able to work along with others to provide high quality service; willing to provide support to other team members who for whatever reason may be unable to fulfil their duties.
10. Supervisory Management Skills:  To oversee, manage and direct the performance of others.

​EDUCATION, TRAINING, KNOWLEDGE & EXPERIENCE

1. Certificate in Insurance Practice/ Degree in relevant field
2. Sound Knowledge of the Elements of Insurance
3. Minimum of two (2) years working experience in insurance claims.
4. Good communication skills
5. Supervisory Management skills (will be an asset)
6. Good interpersonal skills