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Posted November 13, 2019

Job Title: Claims Service Specialist

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About Swiss Re:

The Swiss Re Group is one of the world’s leading providers of reinsurance, insurance and other forms of insurance-based risk transfer, working to make the world more resilient. It anticipates and manages risk – from natural catastrophes to climate change, from ageing populations to cybercrime. The aim of the Swiss Re Group is to enable society to thrive and progress, creating new opportunities and solutions for its clients. Headquartered in Zurich, Switzerland, where it was founded in 1863, the Swiss Re Group operates through a network of around 80 offices globally. It is organized into three Business Units, each with a distinct strategy and set of objectives contributing to the Group’s overall mission.

Position summary:

This position falls within the Swiss Re Life and Health claims team.   The job requires a good knowledge of the fundamentals of claims adjudication in the US life market.  A key part of the job will be to understand the claims landscape and be able to proactively offer the appropriate level of service and support to targeted clients.

The ability to interpret risk signals from both data and client interactions is a core skill required.   The position will work closely with claims colleagues and the Head of Claims Americas to manage the Swiss Re claims portfolio in an efficient and effective manner.

The position location is flexible to either the Armonk, NY office or Fort Wayne, IN office. 

 (Management retains the discretion to add or change the duties of the position at any time.)

Essential Responsibilities

Claims Portfolio Ownership: Work closely with the client managers, client leadership teams and the claims team to evaluate the risk of relevant portfolios from a claims perspective.  Build strong relationships with counterparts in the claims and reinsurance administration departments at Swiss Re's clients.  Provide regular and appropriate insights to clients and to Swiss Re management such that actions can be taken to better manage the business.  Offer appropriate services to clients based on relevant buying behaviour, as defined, and client need.  Ensure that the portfolio is efficiently administered from a claims perspective in particular with respect to the volume of claims managed and quantity and quality of data received having due regard for the size of the reinsurance exposure and riskiness of the underlying business.  Prepare training and assist claims experts and claims service leads with workshops or other presentations as and when required 20%

Claims management:  Oversee administration and adjudication of a sample of claims consistent with established KPIs.   Good understanding of state regulations and industry best practices including but not limited to unfair claim practices, privacy laws, punitive damages legislation and fraud awareness.  Work both with internal stakeholders and clients to manage potential disputes to timely resolution.  Conduct client onsite reviews and/or due diligences of client operations 70%

Research and development: Enhance Swiss Re thought leadership through:

  • Assist with driving new claims solutions and services that will help differentiate Swiss Re in the life insurance market
  • Author and/or provide expert insight for timeous literature on topics relevant to the management of life and health claims risks
  • Actively seek out and evaluate new technologies, techniques and data with a view to better manage claims risks both for clients and for Swiss Re
  • Collaborate with experts, including vendors, to improve claims adjudication processes and procedures internally and with Swiss Re's clients.

Ancillary Responsibilities - duties or activities that are not considered essential functions of the position but are responsibilities this position performs.

Lend claims expertise to unit, regional or global initiatives as and when required.  Provide insights, risk management expertise and innovative thinking; driving projects where necessary. Assist other departments, including technical accounting, underwriting, actuarial, finance, inforce management, portfolio management and treaty with specific ad hoc tasks and joint project work.

Requirements - basic criteria for successful completion of the position’s essential functions.  Please include educational background and relevant job skills/experiences. List any licenses and or certifications required or preferred.

  • Significant technical Life & Health claims expertise across market-relevant products, demonstrated through peer recognition of capabilities in a technical role
  • Experience working in a claims team in a direct office environment a plus
  • Significant awareness of market and portfolio dynamics, including ability to anticipate and mitigate potential risks.
  • Good analytical and research/problem solving skills.  Able to consider data, identify anomalies and use information to develop action plans
  • Strong communication and influencing skills
  • Ability to build inclusive relationships with clients' Claims teams and decision makers
  • Strong collaboration mindset demonstrated through actively fostering cross-functional teamwork 
  • Demonstrated ability to develop and implement differentiating solutions and services
  • Proven decision making skills with ability to exercise judgment in applying 80-20 rule
  • Ability to think innovatively and navigate the unknown effectively
  • Fluent written and spoken English communication skills; Spanish language skills a plus
  • Ideally minimum 10 years related experience, in a reinsurance/ insurance environment
  • Completion of FLMI/FLHC designations or good progress towards at least one of these

Decision Making Level/Position Latitude - describe the type and extent of controls that limit the position's freedom to make final decisions or take action. Please also describe level of supervision required, as well as the impact of errors. 

  • Providing guidance on claims administration and adjudication to cross-functional client leadership teams.
  • Strict accountability for Swiss Re internal governance and authority framework
  • Independent judgment regarding escalation to other levels.

Position Scope Data – please indicate the number of employees that report to this position (both direct and indirect).  Please indicate relevant budget, sales, or other quantifiable measurements for which this position is accountable as well.

  • Responsible for significant portion of total revenue.
  • No direct reports.

Physical Demands – describe the physical working condition under which the job must be performed. Please list such things as mental/visual strain, sitting, standing, lifting, traveling etc.

Most of day spent at the PC, so visual strain or carpal tunnel syndrome may occur.

  • Job completed in a sitting position so physical strain may occur
  • Overtime as required
  • Travel up to 10 times per year
  • Ability to lift up to 20lbs

Swiss Re is an equal opportunity employer. It is our practice to recruit, hire and promote without regard to race, religion, color, national origin, sex, disability, age, pregnancy, sexual orientations, marital status, military status, or any other characteristic protected by law. Decisions on employment are solely based on an individual's qualifications for the position being filled.

During the recruitment process, reasonable accommodations for disabilities are available upon request. If contacted for an interview, please inform the Recruiter/HR Professional of the accommodation needed.

Keywords: expert, adjudicator, claims, fort wayne, armonk, new york, indiana

Reference Code: 86524

Nearest Major Market: White Plains

Nearest Secondary Market: New York City