
AVP Claims – Financial Services
Core Specialty Insurance Holdings, Inc.
full-time
Posted on:
Location Type: Hybrid
Location: Houston • Ohio • Texas • United States
Visit company websiteExplore more
Job Level
About the role
- Responsible for oversight of claims personnel and handling of claims by third party administrators to ensure appropriate and timely resolution of claims.
- Execution of Financial Services business plans and objectives.
- Ensure TPAs and internal employees comply with established claim handling guidelines regarding coverage, investigation, liability, damages, evaluation and resolution.
- Collaborate with audit team to develop and maintain claim audit plans, checklists, and reporting tools.
- Identify and document performance issues, process gaps, and compliance violations; recommend corrective actions and track resolution progress.
- Monitor TPA’s adherence to service level agreements (SLAs) and claim resolution timelines.
- Evaluate the accuracy and appropriateness of claim payments, reserves, and denials made by the TPAs.
- Gather and analyze information to make an accurate evaluation of claims.
- Establish and review reserves pursuant to reserving protocols and reserve authority procedures.
- Monitor performance of claims by reviewing data and reports, sharing information with the division regularly.
Requirements
- Bachelor’s degree (preferably with a Risk Management & Insurance Major) required
- Achieve or working towards an industry designation such as CPCU, CRM, ARM, CIC
- Minimum of 5 years’ experience in claims resolution across the applicable lines of business
- Experience working with support services, including IT, claims, actuarial and operations.
- Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over work authorization sponsorship now or in the future for this position.
Benefits
- medical, dental, vision, and life insurances
- short and long-term disability
- a Company-match of 100% of a 6% contribution 401(k) plan
- an Employee Assistance Plan
- Health Savings Account
- Flexible Spending Account
- Health Reimbursement Account
- wellness program
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claims resolutionclaims handlingfinancial servicesdata analysisperformance monitoringaudit planningcompliance trackingrisk evaluationreserve establishmentSLA monitoring
Soft Skills
collaborationcommunicationproblem-solvingorganizational skillsleadership
Certifications
CPCUCRMARMCIC