Claims Management Specialist

Skill required:

Designation:

Qualifications:

Years of Experience:

About Accenture

What would you do?

• Lead, mentor, and manage a team of claims adjudicators across Marine, WC, and Property portfolios.
• End-to-end adjudication authority: make final decisions on claim approvals, denials, and settlements within defined authority limits.
• Oversee setting reserves, conducting investigations, analyzing coverage, negotiating settlements, and executing closure decisions.
• Audit open and closed file reviews to ensure adherence to internal standards and regulatory requirements -identifying trends, control gaps, and areas for improvement
• Manage escalations from claim examiners, brokers, insureds, or legal teams, providing timely resolution and stakeholder communication.
• Develop and maintain performance packs (weekly, monthly) tracking key metrics (TAT, denial rates, reserve accuracy, loss ratios, escalations) for review during senior leadership calls.
• Lead, mentor, and manage a team of claims adjudicators across Marine, WC, and Property portfolios.
• End-to-end adjudication authority: make final decisions on claim approvals, denials, and settlements within defined authority limits.
• Oversee setting reserves, conducting investigations, analyzing coverage, negotiating settlements, and executing closure decisions.
• Audit open and closed file reviews to ensure adherence to internal standards and regulatory requirements -identifying trends, control gaps, and areas for improvement
• Manage escalations from claim examiners, brokers, insureds, or legal teams, providing timely resolution and stakeholder communication.
• Develop and maintain performance packs (weekly, monthly) tracking key metrics (TAT, denial rates, reserve accuracy, loss ratios, escalations) for review during senior leadership calls. What are we looking for?
• Bachelor’s degree (Insurance, Business, Finance, Law, or equivalent); professional insurance certification preferred.
• Minimum 8 years’ experience in commercial claims adjudication across Marine, WC, and Property.
• Prior experience managing a team of claims professionals—demonstrable leadership, coaching, and escalation handling.
• Experience within International/Marine insurance markets.
• Understanding of regulations and local statutory frameworks.
• Familiarity with Six Sigma, Lean, or process-mapping methodologies.
• Skilled in change management and implementing workflow automation and audit tools. Roles and Responsibilities:
• In this role you are required to do analysis and solving of moderately complex problems
• May create new solutions, leveraging and, where needed, adapting existing methods and procedures
• The person would require understanding of the strategic direction set by senior management as it relates to team goals
• Primary upward interaction is with direct supervisor
• May interact with peers and/or management levels at a client and/or within Accenture
• Guidance would be provided when determining methods and procedures on new assignments
• Decisions made by you will often impact the team in which they reside
• Individual would manage small teams and/or work efforts (if in an individual contributor role) at a client or within Accenture
• Please note that this role may require you to work in rotational shifts