Claims Adjuster - Accident & Health
Core
Assess and evaluate the recoverability of Accident & Health and Travel claims for policies underwritten by the Company.
Role type
Claims Adjuster (Accident & Health)
Builds
Claims settlements and recovery actions
Domain
Insurance (Accident & Health / Travel)
Deliverable
client delivery
Required skills
Claims assessment, Electronic Claim Files (ECF) processing, DOCOsoft system usage, large loss form production, client meeting facilitation, Coverholder/DCA submission review, workflow management, loss fund recovery, error/warning clearance, statistical reporting
Preferred skills
Knowledge of specific line of business
Technologies
DOCOsoft, ECF, LIMCLM, SCMs, USMs
Responsibilities
Handle claims in line with Starr and Lloyd's Minimum Standards; Process Electronic Claim Files (ECF) and Settle Direct claims via DOCOsoft; Manage Claims outcomes including reporting to and sign off by Managers; Produce timely and accurate large loss forms for Senior Management's review; Attend client meetings with Underwriters and/or Claims Managers; Ensure Coverholder / Delegated Claims Administrators (DCA's) submissions are processed on time and compliant; Manage DOCOsoft workflow including diaries and documentation; Review loss fund adequacy and pursue recovery of loss funds; Assist in clearing claims errors/warnings for Syndicate Claims Messages (SCMs) and Underwriter Settlement Messages (USMs) by month end; Monitor and manage ECF/Lirma incompletes; Produce ad-hoc claims reports and statistical support.
Seniority
Mid-level (3-5 years experience)