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Claims Management Specialist Jobs

Company

Entergy
Address , New Orleans, La
Employment type
Salary
Expires 2023-07-10
Posted at 1 year ago
Job Description
Posting End Date: 05/15/2023
Work Place Flexibility: Hybrid
Legal Entity: Entergy Services, LLC
*This position will be filled as Customer Service Specialist I, II or Sr, depending on experience level*

JOB SUMMARY/PURPOSE
Investigates, evaluates and resolves Subrogation claims in assigned geographical jurisdictions, while interacting daily with internal and external stakeholders in order to thoroughly and fairly resolve claims.

JOB DUTIES/RESPONSIBILITIES
  • Identifies opportunities for process improvements and spend/cost reductions, often participating on related teams.
  • Ensures that all claims are properly coded in the claims database with respect to workgroup, cause of incident, charging of payments/recoveries, etc. Ensure thorough running notes and formal reporting is maintained in all claim files per requirements.
  • Interacts with field employees and customer service functions, answering questions, explaining liability and other technical issues, while informing Claims hierarchy of all claim-related circumstances (i.e.: customer complaints, regulatory/executive complaints, etc.) requiring Management intervention/response.
  • Handles claims in assigned territories from start to finish, including thorough liability investigations and resolutions based on sound claims adjusting best practices and company guidelines. Oversees the activities of contracted vendors when utilized.
  • Ensure thorough claim-status communications when appropriate to Legal, Risk Management, excess insurance broker/carriers, etc., including timely issuance of reports when appropriate.
  • Participates in Safety training/reporting programs, storm response teams and in acts of volunteerism.
  • Follows protocols in establishing reserves/receivables and securing settlement authority per guidelines. Ensures all claims are properly documented and assertively handled. Ensure all claims are properly reserved for anticipated liabilities or recoveries, reviewing reserve adequacy at least once per month, and properly requesting authority to adjust large reserves.
  • Ensures completion of thorough internal claim-status communications to management/leadership and other departments as appropriate.

MINIMUM REQUIREMENTS
Minimum education required of the position
Bachelor's degree, generally in Liberal Arts, Business, Insurance or Health Administration. Master’s degree a plus.

Minimum experience required of the position
Customer Service Spec I: 3-5 years of liability claims adjusting experience with property & casualty insurer, third-party administrator or self-insured employer group.
Customer Service Spec II: 5+ years of liability claims adjusting experience with property & casualty insurer, third-party administrator or self-insured employer group.
Customer Service Spec Sr: 10+ years of liability and/or subrogation claims adjusting experience with property & casualty insurer, third-party administrator or self-insured employer group.

Minimum knowledge, skills and abilities required of the position
  • Commitment to Safety.
  • Ability to explain difficult or sensitive information; works to build consensus.
  • Ability to work independently in a fast-paced environment with diverse internal/external stakeholders
  • Ability to explain the processes of investigating, evaluating, negotiating, resolving, documenting and reporting-on complex claims. Understanding elements of compensability, legal liability, fact-finding/discovery and methods for claim adjudication. Ability to communicate with all levels throughout an organization, resolve conflict, accept push-back and criticism, understand “economic” decision-making, prioritize work, operate standard computer applications, successfully answer required behavior-based questions.
  • Impacts a range of customers, operational, project or service activities within own team and other related teams; works within broad guidelines and policies.
  • Acts as a resource for colleagues with less experience; may lead projects with manageable risks and resource requirements.
  • Solves complex problems; takes a new perspective on existing solutions; exercises judgment based on the analysis of multiple sources of information.
  • Understanding elements of legal liability, fact-finding/discovery and methods for claim resolution/adjudication.
  • Ability to prioritize and organize work.
  • Ability to operate computer applications, such as Word, Excel, PowerPoint and claims database.

Any certificates, licenses, etc. required for the position
Licensed Claims Adjuster (may be secured within the first year of employment). Desired: Industry claims designation (SCLA, CWCP, AIC, etc.).

#LI-JL1
#LI-HYBRID

Primary Location: Louisiana-New Orleans Louisiana : New Orleans
Job Function: Professional
FLSA Status: Professional
Relocation Option: No Relocation Offered
Union description/code: NON BARGAINING UNIT-NBU
Number of Openings: 1
Req ID: 110689
Travel Percentage:Up to 25%

An Equal Opportunity Employer, Minority/Female/Disability/Vets. Please click here to view the EEO page, or see statements below.
EEO Statement: The Entergy System of Companies provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a protected veteran in accordance with applicable federal, state and local laws. The Entergy System of Companies complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment including, but not limited to, recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
The Entergy System of Companies expressly prohibits any form of unlawful employee harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of the Entergy System of Company employees to perform their expected job duties is absolutely not tolerated.
Accessibility: Entergy provides reasonable accommodations for online applicants. Requests for a reasonable accommodation may be made orally or in writing by an applicant, employee, or third party on his or her behalf. If you are an individual with a disability and you are in need of an accommodation for the recruiting process please click here and provide your name, contact number, the accommodation requested and the requisition number that you are requesting the accommodation for. Employee Services will contact you regarding your request.
Additional Responsibilities: As a provider of essential services, Entergy expects its employees to be available to work additional hours, to work in alternate locations, and/or to perform additional duties in connection with storms, outages, emergencies, or other situations as deemed necessary by the company. Exempt employees may not be paid overtime associated with such duties.
Entergy Pay Transparency Policy Statement: The Entergy System of Companies (the Company) will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company’s legal duty to furnish information. 41 CFR 60-1.35(c). Equal Opportunity and Pay Transparency.
Pay Transparency Notice:
Pay Transparency Nondiscrimination Provision (dol.gov)
The non-confidential portions of the affirmative action program for individuals with disabilities and protected veterans shall be available for inspection upon request by any employee or applicant for employment. Please contact [email protected] to schedule a time to review the affirmative action plan during regular office hours.
WORKING CONDITIONS:
As a provider of essential services, Entergy expects its employees to be available to work additional hours, to work in alternate locations, and/or to perform additional duties in connection with storms, outages, emergencies, or other situations as deemed necessary by the company. Exempt employees may not be paid overtime associated with such duties.