Senior level claims position to review reports provided by unit managers that have high potential or complex issues. Ability to attend round tables, client meetings, mentor managers and adjusters and assist management with analysis as requested. Ensure reports to the client’s oversight are of high quality and address all potential issues and adhere to Client Claims Handling Guidelines and NARS Best Practices. Reviews claims that are reported, screens for claims that have high exposure that may not be reported to the appropriate level. Assists in the training and development of managers and adjusters. Provides technical direction in claims and facilitates reporting to internal and external customers, carriers, reinsurers, brokers, and agents. Oversees day to day administrative duties required within the claims units. Other miscellaneous duties as assigned, which may include travel.
Essential Duties and Responsibilities:
- Able to efficiently manage pending of at least 150 large or high potential claims.
- Provides insight, guidance, and suggestions involving the investigation, evaluation, defense, and settlement of claims.
- Ensure adherence to all file handling standards, NARS Best Practices, Client standards, state statutes and requirements necessary to pass audits performed by regulatory agencies, carriers and clients. Form well written emails and LLR's internally and externally.
- Ensure that all files on report are effectively handled; following processes set out by management and/or directed in client guidelines.
- Responsible for overseeing adequate reserving of claims, claim quality, and the efficient handling of files assigned to each unit reporting to the analyst.
- Participates, often leading, roundtables, leadership management meetings, training programs and contributes their interactions and outcomes.
- Maintain appropriate diary on claims under review.
- Works with file handlers on an individual basis to ensure compliance with all state and regulatory reporting requirements in every jurisdiction serviced.
- Maintain and communicate legislative actions, court decisions, industry trends and developments to the units in all lines of business serviced, as applicable.
- Provides feedback to unit managers, directors, and the President of the technical expertise and capabilities of the file handlers in all reporting units.
- Through technical direction, work to guarantee success in any program or work that comes to the organization.
- Provides information and suggestions to the directors for any programs handled by the branch.
- Perform other duties as assigned that may include, but are not limited to, providing audit support, research, marketing, or back up support for other areas within the organization (travel may be required).
- Bachelor’s Degree in management preferred, with 15+ years claim handling experience.
- Must have 10+ years supervisory and administrative experience.
- Must be eligible for reserve/payment authority level of $100,000+ (where client appropriate)
• Must possess, or have the ability to obtain, a current state of domicile adjuster’s license, as well as other required jurisdictional licensing.
• Advanced legal/claims/analytical skills and ability to communicate them to others not under direct management supervision.
• High level of interpersonal skills to handle sensitive and confidential situations and information.
- Requires advanced technical skills and ability to assist Claims Unit Adjusters, Assistant Unit Managers and Unit Managers with claim direction and settlement negotiations with attorneys and arbitrators on first and third party claims.
• Requires advanced ability to work independently.
• Requires advanced level of organization and time management skills.
• Must possess superior level of written and verbal communication skills.
• Must be able to analyze claims data, explain and appropriately respond to auditors, clients and potential clients during in-person or over the phone presentations.
• Advanced knowledge of a variety of computer software applications in word processing, database and presentation software (Microsoft Office platform).
- Must be a proven leader to be able to synthesize information competently and present it to management, staff and some external customers in either oral or written form.
• Requires some travel including overnight and weekends as needed.
• Willingness to work flexible hours.
• Requires some lifting of boxes (marketing materials and displays) up to approximately 20 pounds.
• Ability to persuade and influence others.
• Ability to develop and deliver presentations.
• Ability to create, compose and edit written materials.
- Must be available 24/7.
• Repeated use of keyboard, mouse and exposure to computer screens from either a desktop or laptop computer.