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Sr. Claims Specialist, Accident and Health

  • Location:

    United States Virgin Island

  • Sector:

    Underwriting & Claims

  • Job type:

    Permanent

  • Salary:

    Negotiable

  • Contact:

    Brian Wagner

  • Contact email:

    brian.wagner@oliverjames.com

  • Job ref:

    JOB-112024-263508_1731514602

  • Published:

    circa 1 mesi fa

  • Expiry date:

    2024-12-13

Title: Senior Accident & Health Claims Specialist

Location: Remote (Occasional travel required)
Job Type: Full-time
Industry: Insurance/Reinsurance

About Us:
Join a leading insurance and reinsurance provider, offering innovative solutions in Accident & Health claims. We're seeking an experienced Senior Accident & Health Claims Specialist to join our team. This role will involve managing claims, collaborating with vendors, and ensuring alignment with our business goals.

Key Responsibilities:

  • Review and process Accident & Health claims; interpret reinsurance contracts and policy language.
  • Analyze claim eligibility, coverage issues, and ensure proper provisions and limits.
  • Work with vendors, brokers, and clients to resolve claims issues.
  • Lead claims committees, report on large losses, and present recommendations to management.
  • Maintain accurate claim records and ensure timely reimbursements.
  • Participate in industry events and ongoing professional development.

Requirements:

  • 10+ years of experience in Accident & Health claims (HMO reinsurance, Stop Loss, Managed Care).
  • Proficiency with reinsurance treaties, policy interpretation, and Microsoft Excel.
  • Strong analytical, problem-solving, and communication skills.
  • Ability to work independently and collaboratively across teams.
  • Bachelor's Degree or equivalent experience in insurance, reinsurance, or financial services.
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