Program Services Audit - Claims

POSITION SUMMARY:

The Program Services Audit – Claims position performs claim audits of Trean’s partners as well the direct business of Trean’s carriers. This position will conduct both electronic and on-site audits of the claim files and processes of our partners.

RESPONSIBILITIES:

• Plan and schedule claim audits for all assigned Programs.
• Audits include adherence to guidelines, including accuracy, consistency and compliance.
• Assists in developing effective follow-up procedures, systems and management reports that will ensure Program Partners’ and/or TPA’s compliance to audit findings and recommendations.
• Reporting of claims to reinsurers/reinsurance broker that meet reporting criteria.
• Plan and schedule audit wrap meetings as required on any assigned Programs.
• Work with our partners if they have specific claim questions
• Assists in providing claims data and analysis to our independent actuary
• Research industry claim issues and make recommendations to update our claims best practices.
• Representation of Trean with Industry Groups (SAWCA, WCI, etc.)
• Approximately 35% travel required.
• Perform other activities, duties and assignments as needed or requested
• Eligible for remote or hybrid work arrangement

MINIMUM QUALIFICATIONS:

• Bachelor’s degree.
• Industry designations preferred (AIC, ARM, CPCU).
• 5-7 Years Property/ Casualty claims experience to include commercial general liability, commercial automobile/trucking/transportation. Secondary workers’ compensation experience will be considered on a case-by-case basis. This experience should be as a desk adjuster with ownership of the claims decisions, documentation, reserving, vendor assignment and management, litigation oversight, reporting to carriers, reinsurers, and other stakeholders along with heading up negotiations and settlement on claims assigned.
• Working knowledge of laws and regulations relevant to Claims standards, processes and procedures.
• Working knowledge of claim systems.
• Working knowledge/experience working with MSOffice, Word, Excel, Powerpoint, Outlook, Teams.
• Experience with Sales Force preferred.
• Experience working with RMIS platforms
• Experience handling large loss reserves and settlements
• Flexible and adaptable to change.
• Able to work independently, self-manage time, assignments and work-schedule in order to satisfy all deadlines on work assigned.
• Must be customer focused internally and externally.
• Interpersonal and teamwork skills are needed.

CONFIDENTIAL INFORMATION:

All information (written, verbal, electronic, etc.) that an employee encounters while working at the Company is considered confidential. Reference corporate policies, guidelines and applicable laws.

WORKING CONDITIONS

This position is located in a professional office environment. This role routinely uses standard office equipment and requires the physical demands of a normal office position with some light lifting. This is a full-time position with benefits. This can be a remote or hybrid position. If it is remote, you must be able to provide a space in your home that is quiet and enables productivity, participation in required meetings/calls and presents a professional environment to facilitate your work.

DISCLAIMER

This job description is not a contract of employment. It represents the minimum requirements of the job and includes the major responsibilities but not all responsibilities. Trean Corporation will change and update this job description, as necessary. Any employment with Trean Corporation will be “at will,” meaning that either you or the Company may terminate your employment at any time and for any reason, with or without cause or advance notice.