Job Description📣 We're Hiring: Client Claims Director💼
Business Segment: Broadspire🔍 Role Overview:• Serve as the primary claims liaison for a designated client, driving program enhancements, client-specific directives, and claims process improvements.
• Partner with Adjusters, Team Leaders, Team Managers, and Service Center Managers to enhance claim quality, staffing strategies, operational efficiency, and claim outcomes.
• Monitor claim performance through analytics, ensuring compliance with client Special Handling Instructions, Best Practices, and service expectations.
• Oversee claim operations, including investigations, reserve management, workflow optimization, litigation management, and claim file audits.
• Coach and educate claim staff on customer service, technical claim handling, supervision standards, reserve controls, data accuracy, and quality results.
• Manage client reporting and statistical data while ensuring effective utilization of Medical Management Services, Subrogation Vendors, SIU Services, Attorneys, and other program resources.
Responsibilities- Assists in the section, training and development of an effective and efficient staff.
- Monitors key metrics on a daily, weekly or monthly level as needed. Key metrics include general metrics as well as those specifically targeting client initiatives.
- Along with Account Executive, communicates Client's expectations and ensures compliance via interaction with Team Manager and Service Manager.
- Provides claim specific guidance to staff as applicable ensure proper investigation and timely equitable disposition of claims. Makes recommendations on reserves exceeding pre-determined authority level; conducts periodic reserve reviews to identify areas of concern and work with Team Manager to resolve.
- Analyzes files on a periodic basis to determine accuracy and completeness and to maintain control of quality of work.
- Works with Team Manager and Service Center Manager to ensure that claim personnel are knowledgeable on client special handling instructions, carrier requirements and work reflects same.
- Keeps VP of Claim Operations informed verbally and in writing of activities and problems within assigned area of responsibility; refers matters beyond limits of authority and expertise to SVP and VP of Claim Operations.
- Participates in special projects or performs duties in other areas as requested.
- Undertake reviews, based on predetermined criteria or as applicable, to ensure proper investigation and data collection.
- Works with staff to ensure training has taken place in the proper evaluation of claims from a legal, medical, and financial standpoint.
- Handle client concerns quickly and efficiently to resolution
Qualifications- College Degree preferred or education equivalent to a college degree or the equivalent experience in related work experience.
- Seven more years of progressive technical claim experience, including supervisory and/or management experience, demonstrating a high degree of judgment and discretion, is capable of providing adequate guidance and support on administrative and technical claim matters.
- Attainment of the Associate in Claims designation, and successful completion of, or active study for, I.I.A. MGT 43, and MGT 44, or the equivalent in related studies or work experience.
- Demonstrated ability to supervise the work of others.
- Demonstrates effective and diplomatic oral and written communication skills, and promotes a favorable company image to the public.
- None
#LI-EM3
- The Pay Range/Salary represents the anticipated low and high pay that may be offered for this position. To determine the actual offer, Crawford considers a wide range of factors including the candidate's previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours.
- Bonus/Incentive Pay and other Performance-Based Rewards, if applicable.
- We offer a well-rounded benefits package that encourages wellness and helps our employees to be an educated healthcare consumer. The core benefits* offered include:
- Medical, Dental and Vision Plans
- Prescription Drugs
- HSA, HRA, and FSA Accounts
- Paid Holidays, Vacation and Sick Leave
- 401(k) Retirement Plan
- Tuition Assistance
- Paid Parental Leave
- Supplemental Health Benefits
Other Benefits currently available at no cost include: - Enhanced Mental Health Support
- Virtual Physical Therapy
- Caregiving Services
- Life Assistance Program
*The above information highlights some of the benefits currently available to eligible full-time employees.
- Training programs that promote continuous learning and career progression while enhancing job performance.
- Sustainability programs that give back to the communities in which we live and work.
- A culture of respect, collaboration, entrepreneurial spirit and inclusion.
