Claims Advocate - Risk Services
Insurance Office of AmericaAbout the role
Job Description:
Title: Claims Advocate – Risk Services
Fully remote out of the West Coast
Please note: If this position is posted as either fully remote and/or hybrid, in accordance with company policy, individuals residing within a 50-mile radius of a branch location may be required to work onsite in a hybrid capacity. Additionally, there may be occasions when on-site presence is necessary to meet specific business needs. Learn more about our locations here: ioausa.com/locations
About the Role: Responsible for IOA insurance Claims Management activities including: client advocacy, service and communication, problem claim resolution, data analysis and action, monitoring triggered activities, claims reviews and audits, workers compensation claim oversight, reserve analysis, unit stat and stewardship reporting, client education and consulting, sales support, litigation process management, new client onboarding, intake process support, data management and entry, and Producer communication.
Key Responsibilities:
Performance Standards: Meet all production, quality, and service expectations.
Client Service Excellence: Deliver outstanding service by anticipating client needs and responding promptly.
Client Advocacy: Serve as a dedicated advocate, providing high levels of ongoing support and consultation.
Problem Claim Resolution: Manage complex or delayed claims to ensure timely and favorable outcomes.
Loss Report Analysis: Review aggravated inequity loss reports and take appropriate corrective actions.
Activity Monitoring: Track triggered claim activities and implement necessary follow-up actions.
Claims Review & Auditing: Conduct and participate in formal claims reviews and audits.
Workers Compensation Oversight: Monitor workers compensation claims via the IOA Claims Portal and drive them to closure.
Reserve Accuracy: Perform reserve analysis to ensure timely and accurate case reserves in line with best practices.
Carrier Relationship Management: Build and maintain strong relationships with carriers to influence positive claim outcomes.
Claims Mediation: Act as an intermediary between clients and carriers to facilitate effective and timely resolutions.
Client Education: Provide ongoing education on statute changes, state-specific procedures, and claims best practices.
Trend Identification & Risk Mitigation: Identify claims trends, recommend risk mitigation strategies, and collaborate with Risk Advocates.
Sales Support: Assist with Producer presentations and contribute to sales efforts through claims insights.
Reporting & Documentation: Prepare and deliver stewardship and unit stat reporting in accordance with departmental standards.
Ideal Candidate Qualifications:
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