Claim Representative

Job Title: Senior Claim Representative

Summary
The Senior Claim Representative is a high-impact leadership role responsible for the end-to-end strategic execution of the agency’s claims handling process. This position serves as a critical client advocate, providing technical oversight for large and complex P&C claims (Property, Liability, Workers’ Comp, Automobile, and Professional Lines). You will be part of a dedicated two-person claim team to ensure prompt, fair resolutions while acting as the primary technical liaison between clients, account managers, and insurance carriers to minimize total cost of risk.

Essential Duties and Responsibilities

• Strategic Advocacy & Settlement: Coordinate the settlement process for complex claims, advocating for clients on coverage denials, Reservation of Rights letters, and high-exposure settlements.

• Operational Excellence: Execute daily department workflows, including claim reporting timeliness, diary systems, and claim closing targets to ensure high-efficiency standards.

• Client Stewardship: Conduct proactive "claim review meetings" with key clients and account teams; provide actionable loss-run analysis to identify risk trends and recommend cost-containment strategies.

• Reporting & Communication: Deliver weekly high-level briefings to department leadership on new activity, diary status, and severe losses.

• Carrier & TPA Management: Establish qualifications for and monitor the performance of third-party administrators (TPAs) and carrier adjusters to ensure adherence to agreed service levels.

• Financial Oversight: Anticipate and administer substantial financial changes in claims (reserves/settlements) and rigorously monitor coverage denials to protect client interests.

Required Qualifications & Skills

• Experience: 7–10+ years of P&C claims handling experience.

• Technical Expertise: Mastery of P&C coverage lines, including General Liability, Workers’ Comp, Professional Liability, and Commercial Property.

• Licensing: Active Property & Casualty Adjuster or Broker License is highly preferred.

• Soft Skills: Advanced negotiation, analytical, and interpersonal skills; ability to navigate high-stakes conflict between clients and carriers.

• Systems: Proficiency in Agency Management Systems (e.g., Applied Epic) and MS Office Suite.

• Education: Bachelor’s degree in Business, Risk Management, or Finance preferred; industry designations (e.g., CPCU, AIC, or ARM) are a major plus.

Key Performance Indicators (KPIs)

• Claim Cycle Time: Reduction in days from first notice of loss (FNOL) to closure.

• Client Retention: Maintaining high satisfaction levels through effective advocacy.

• Settlement Efficiency: Percentage of claims successfully resolved within target timeframes.

Compensation: The base salary range for this role is $90,000-$100,000.  Actual compensation will be based on factors including location, skills, experience, and internal equity. Cross Insurance offers a comprehensive benefits package including medical, dental, vision, 401(k) with match, paid time off, and more.

DISCLAIMER:

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.