Claims Advocate

Claim Advocate

Oxford Risk Management Group, LLC was founded in 2010 and continues to provide the highest caliber of captive insurance in the nation. We excel in offering various claims services tailored to Enterprise Risk Management and Limited Lines Captive programs.

The Claim Advocate position is the liaison between our Captive participants, brokers, and Third-Party Administrators regarding all related claim matters. Claim Advocates take a proactive approach to advocate on behalf of the Captive for the best possible claim outcome and employ their best efforts to ensure that the captive's interests are protected by insurance policies placed with one of ORMG's fronting carriers.

Primary Responsibilities :

• Manage a portfolio of captive insurance accounts with premiums less than $8,000,000 combined.
• Oversee all claim-related processes, which include assessing applicable coverage, facilitating investigations, determining liability, participating in litigation, reserving, and settlements.
• Provide comprehensive oversight and support to Third-Party Administrators (TPAs) to ensure effective claims management.
• Act as a liaison between the captive insurance entity and the TPA to address coverage issues and facilitate resolutions, including conducting internal discussions as needed.
• Advocate proactively for captives in all facets of claims management to ensure optimal outcomes.
• Conduct needs assessments to establish effective reporting procedures and enhance claim handling services.
• Deliver technical expertise to address inquiries from captives regarding claim-related matters.
• Collaborate with cross-functional departments to ensure clear communication and efficient operations, offering technical support to other operational teams.
• Maintain awareness of TPA agreements, pricing structures, and service guidelines to ensure compliance and quality of service, includingbut not limited tocash calls, pricing issues, loss run errors, or filing and pursuing E&O claims with TPAs.
• Review and disseminate communications to adjusters, captive members, and brokers, ensuring all parties are informed.
• Address and mediate questions or concerns from insured parties, adjusters, and brokers to resolve disputes effectively.
• Engage in claim reviews, stewardship meetings, and claim committee discussions.
• Perform quarterly audits per captive, with a minimum of three. Notify and take the necessary action with TPAs.

Requirements and Qualifications :

At Risk Strategies Company, base pay is one part of our total compensation package, which also includes a comprehensive suite of benefits, including medical, dental, vision, disability, life, and retirement savings, The total compensation for a position may also include other elements dependent on the position offered. The expected base pay range for this position is between $64,800.00-90,000.00 The actual base pay offered may vary depending on multiple individualized factors, including geographical location, education, job-related knowledge, skills, and experience.

Risk Strategies is an equal opportunity workplace and is committed to ensuring equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, Veteran status, or other legally protected characteristics. Learn more about working at Risk Strategies.