This position will manage and provide technical direction to the Claims Analyst and/or Claims Technician positions within a multi-disciplinary regional claims team setting involving medical and legal claims professionals. The Regional Claims Manager will provide guidance regarding workers compensation and employer liability issues as they pertain to coverage, loss exposure, and file resolution, including settlement. This position will manage the quality of claim handling via the various quality assurance programs to ensure staff adherence to and compliance with established standards of claim handling performance. The Regional Claims Manager will report to the Director of Claims.
Responsibilities:
Maintain technical and regulatory expertise in all assigned jurisdictions. Monitor judicial and legislative entities to promptly identify, analyze and communicate changes impacting jurisdictional exposures and claim handling.
Provide technical claims leadership to the Claims Analysts in the investigation and handling of all referred claims. Ensure claim management and case reserves are consistent with company guidelines and philosophy.
Provide daily coaching to the regional claims staff on coverage, investigation, evaluation, reserving, and resolution of claim files.
Utilize performance management and performance review processes effectively, on an ongoing basis, to maximize staff performance.
Identify training needs of staff and recommend solutions.
Communicate the status of all referred claims to appropriate internal and external business partners.
Provide technical claims support to internal business partners.
Promptly investigate all assigned claims for coverage, exposure, subrogation/recovery, and resolution.
Address all reserving, payment, and settlement requests within positions authority.
Conduct scheduled and periodic file reviews to ensure compliance with company standards.
Assemble and analyze claim results data to evaluate status relative to established objectives. Report on observation and recommend remedial action.
Achieve operational business plan goals ensuring regulatory compliance with legal statutes, policy provisions and company guidelines.
Communicate, and ensure compliance with corporate policies and procedures.
Job Requirements
Bachelors degree preferred with 5-7 or more years of equivalent work experience in an insurance related industry required.
3-5 years supervisory or management experience preferred.
Advanced skills in coverage analysis, negligence principles, investigative and negotiation techniques.
Strong organizational skills and detail oriented.
Ability to work independently and handle multiple tasks simultaneously.
Strong working knowledge of workers compensation and employer liability claims.
Excellent verbal and written communication skills.
Excellent customer service and collaboration skills.
Extensive knowledge of workers compensation regulations and applicable law, preferably in multiple jurisdictions.
Extensive knowledge of insurance contracts and adjusting techniques. Familiarity with medical terminology, legal procedures and claim evaluation.
Demonstrated coaching, influencing, and teamwork skills.
Computer literacy, including working knowledge of MS Office Product Suite, i.e. WORD, Excel, PowerPoint.
Previous supervisory experience required.
Chartered Property Casualty Insurance (CPCU); Associate in Claims (AIC), Senior Claim Law Associate (SCLA) designation or similar professional designation preferred.
Litigation and vendor management skills preferred.
Willingness to travel for business purposes; Travel is approximately 10%.
Saeger Search
Jeff Saeger, CPC
1108 Olive Street Blvd, Suite 100
jeffsaeger@sbcglobal.net
St.Louis, MO 63101
(314)621-7555
(314)621-2683 -- fax
jeffsaeger@sbcglobal.net
http://www.saegersearch.com
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