Senior Claims Specialist- Accident & Health at Chubb in Wilmington, Delaware

Job Description:

• Work closely with Third Party Administrators and Claim Managers on successful implementation of business plan.


• Conduct claims performance/quality/audit reviews of Regional Claims Offices and TPA offices.


• Measure performance opportunities through use of file/re-inspection process, and/or audit process.


• Interact with various levels of claims management to communicate audit findings, recommend solutions to continuous process improvement, and monitor results.


• Assist with new claim TPA due diligence reviews, review and respond to Department of Insurance inquiries, work closely with the field operation sales force, underwriting and other home office staff.  Frequent interaction with ACE Senior Management.

• Strong background in Operations, Claim Processing, Auditing and Microsoft Office Systems is necessary.


• 3 - 5 years of auditing Accident and Health Claims processing, AD&D claim processing or claim investigation experience preferred. 


• Experience with case management process and ability to implement case management processes with clients.


• Understanding and ability to effectively mange PPO networks to ensure cost savings measures.


• Experience in managing external business partners to enhance work flow and communications.   


• Strong communication and writing abilities.


• Ability to interact with senior management both internally and with our external business partners


• Bachelor’s degree or proven insurance related experience.


• Proven track record handling all types of Accident & Health claims. 


• Able to work under tight deadlines with limited oversight.


• 30% travel required.