Claims Specialist at MMC in Metairie, Louisiana

Job Description:

SUMMARY:



As a Claims Specialist for the Marsh McLennan Agency, you will be a claims consultant providing oversight and advocacy on behalf of our clients throughout the process of a loss event and the life of a claim. This position is client facing and requires single-day regional travel to our client locations.


Duties include:

• You will submit claims or provide guidance on claim submission;


• Compiles Risk Services Plans (RSPs);


• Monitors RSPs to ensure we are delivering all services as promised;


• Review coverages and resolve claims issues;


• Compiles & delivers Stewardship Reports to clients;


• Compiles e-mod forecasts & delivers e-mod analytical reports;


• Assists clients in finding solutions for problematic modifiers;


• Reports claims to insurance carriers, assisting in the communication between clients and adjusters;


• Ensure carrier commitments are honored;


• Coordinate and participate in scheduled claims reviews;


• Serve as your client's advocate with adjusters and their coverage counsel;


• Resolve coverage disputes whenever possible;


• Assess and strategize to produce best possible claim outcomes;

Duties may also include:

• Review of client's overall claims program and individual complex claims situations;


• On-site visit when a catastrophic loss occurs;


• Completes Open Claims Reviews


• Develop strategic action plans to reach desired outcomes;


• Provide guidance regarding potential large settlements;


• Recommend suitable vendor partners, including claims TPAs, nurse triage, and others;


• Review adjuster's claim action plans; facilitate claims resolutions;


• Evaluate insurance company claim reserves and push for reductions where appropriate;

REQUIREMENTS:

• High School Diploma, Bachelor's degree preferred;

• Adjusters license;


• Knowledge of accepted industry standards and practices;

• Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges;


• Analytical skill necessary to make decisions and resolve issues inherent in handling of claims;

We embrace a culture that celebrates and promotes the many backgrounds, heritages and perspectives of our colleagues and clients. Marsh & McLennan Agency offers competitive salaries and comprehensive benefits and programs including: health and welfare, tuition assistance, 401K, employee assistance program, career mobility, employee network groups, volunteer opportunities, and other programs. For more information about our company, please visit us at: http://marshmma.com/careers.


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