Reinsurance Claim Specialist

Reinsurance Claim Specialist Job Description

Job Family Grouping: Reinsurance Claims

Job Family: Claims

The Accident & Health Reinsurance Claims Specialist is a key contributor to the reinsurance team at AXIS.

Working in a globalized customer focused, reinsurance claims organization, you will support the department goals of providing best in class, professional internal and external client service through efficient and effective reinsurance claims handling and customer support as needed. As a Reinsurance Claims Specialist, you will proactively manage a diverse and interesting portfolio of Accident and Health reinsurance claims.

How does this role contribute to our collective success?

The Accident and Health Reinsurance Claims Specialist is diligent in reviewing reinsurance claims against our treaties to protect the assets of AXIS and ensure we are paying all claims properly presented as quickly and efficiently as possible, while maintaining accurate records and providing high quality service.

What will you do in this role?

• Proactively manage claims from notification through closure, investing the necessary level of involvement required for each claim depending on the nature of it.

• Analyze and determine eligibility of claims, verify claims are correctly ceded and verify proper policy provisions and limits are applied.

• Establish and monitor appropriate reserves.

• Resolve claims questions directly with cedents or brokers in a professional manner.

• Engage with cedents, brokers and 3rd party vendors, to identify opportunities to assist in mitigation of claims utilizing a suite of cost containment services.

• Collaborate with other team members, including technical accounting, to get valid claims paid accurately and promptly within your authority level.

• Conduct claim audits for existing accounts/clients. Travel may be required.

• Collaborate with AXIS Re colleagues by sharing pertinent loss development information with underwriters and actuaries.

• Build strategic relationships in the industry to support informed and best in class reinsurance claims handling.

• Interact with colleagues across the organization to support strategic initiatives.

• Identify developing trends and anomalies in your book of claims and recommend appropriate strategies which could include changes to procedures, cost containment strategies, and client or peer education presentations, among other strategies.

• Participate in professional associations/professional development activities and industry conferences to gain expertise, industry information and insights, and to network.

• Identify process improvements to be reviewed and approved by more senior management.

• Engage in department wide initiatives.

• May be asked to prepare presentations for clients or colleagues from time to time.

You may also be required to take on additional duties, responsibilities and activities appropriate to the nature of this role.

About You:

We encourage you to bring your own experience and expertise to the table, so while there are some qualifications and experiences, we need you to have, we are open to discussing how your individual knowledge might lend itself to fulfilling this role and help us achieve our goals.

What you need to have:

• Bachelor's Degree or equivalent experience in insurance or reinsurance.

• 5+ years experience with Employer Stop Loss, Fully Insured, and Managed Care claims adjudication.

• A firm understanding of insurance and reinsurance terminology, including familiarity with various lines of business insurance coverage and reinsurance treaty types.

• The ability to evaluate insurance claims and exposures for proper reserving under a reinsurance program.

• An understanding of common reinsurance contract terms and conditions, including business covered, common exclusions, aggregate limits, treaty limits, retentions, how to apply annual aggregate deductibles, and the impact of the reinsurance contract terms and policy conditions to each claim.

• Ability to communicate with brokers and cedents in a timely and concise manner.

• Strong Microsoft Word and Excel skills

What we prefer you to have:

• High standard of professional conduct.

• Strong analytical and organizational skills.

• Ability to liaise with individuals across a variety of operational and technical disciplines.

• Ability to read and interpret medical reports, clinical experience a plus

Role Factors:

In this role, you will typically be required to:

Travel to cedents and broker meetings in North America between 2-5 times a year.

Be in the office 3 days per week minimum.