Senior Claims Specialist - TPA Liability

AXA SA$117K — $184K *
Finance & Insurance
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 5-7 years of advanced claim handling experience in high-value/complex claims and litigation management.
  • Expertise in managing coverage and compliance issues.
  • Experience working across multiple U.S. jurisdictions.
  • Specialization in Automobile, Construction, and General Liability lines of business.
  • Experience managing claims under an unbundled insurance model.
  • Familiarity with New York Labor Law preferred; knowledge of worker's compensation and employers' liability is a plus.
  • Effective communication, negotiation, and organizational skills.

Responsibilities

  • Manage a caseload of high-value liability claims across the U.S. for various clients.
  • Coordinate coverage referrals and compliance issues with Third Party Administrators (TPAs) and internal departments.
  • Oversee TPAs according to company best practices during all claim phases.
  • Guide TPA claim adjusters on key claim handling processes.
  • Collaborate with business partners on claims strategy for optimal outcomes.
  • Engage with internal claim resources to mitigate expenses and enhance claim resolution.
  • Perform Claim Account Management and participate in TPA audits.

Benefits

  • Competitive retirement savings plan.
  • Comprehensive health and wellness programs.
  • Opportunities for professional learning and career development.
Full Job Description
What you'll be doing

What will your essential responsibilities include?
  • Active management of caseload of high-value liability claims venue throughout the United States for assigned clients in our US Risk Management, Construction, Programs and other supported business units.
  • Effectively coordinate coverage referrals and compliance related issues with Third Party Administrators (TPAs), Claim Management and our Compliance Department.
  • Conduct claims handling and oversight of TPAs in accordance with AXA XL best practices in the major phases of claim handling including coverage, investigation, evaluation, reserving, recovery, and resolution.
  • Provide oversight, guidance and direction to TPA claim adjusters on all major phases of claim handling including coverage, investigation, evaluation/reserving, recovery, and resolution.
  • Collaborate with business partners, as appropriate, on claim management and strategy to help deliver the most optimal outcome and ensure, to the extent possible, that we are in alignment on our evaluation of the exposure and strategy to resolve.
  • Collaborate and consult with internal claim resources such as regional practice leaders and claim legal to ensure the most optimal outcome and mitigate claim expense.
  • Perform Claim Account Management for assigned clients to communicate claim issues and results, participate in the TPA audit process, and collaborate on technical and service issues relating to the TPA performance and the client.
  • Collaborate proactively with internal and external stakeholders regarding claim experience, results, and trends (e.g. actuarial, reinsurance, credit risk and underwriting).
  • Provide input into the development of key metrics to support Claim Audits and assist in the coordination and retention of external counsel, as needed.

You will report to the Claims Manager - TPA Liability.

What you'll bring

Required Skills and Abilities:
  • Advanced claim handling experience involving high value/complex claim management and litigation management.
  • Defined expertise in managing coverage and compliance related issues.
  • Multi-jurisdictional (U.S.) experience.
  • Demonstrated expertise in designated line(s) of business: Automobile, Construction, and General Liability.
  • Experience managing claims in an unbundled insurance model.
  • Experience with NY Labor Law desired.
  • Overall knowledge of worker's compensation, employers' liability desired, but not required
  • Leadership: Demonstrates managerial courage and ability to influence actions of external relationships. Coaches, sets expectations, evaluates and holds people accountable for delivering.
  • Effective communication and negotiation skills: Excellent verbal and written communication, and negotiation skills.
  • Effective organizational and time management skills.
  • Strategic thinking: Exhibit ownership to look for ways to continuously improve internal processes as it relates to improving claim outcomes and managing the performance of external relationships.
  • Effective teamwork/collaboration skills in order to effectively collaborative with Regional Practice Leads, Claim Legal, TPA and clients to produce desired outcomes, as well as with other internal and external stakeholders such as, brokers, actuarial, reinsurance and business partners to communicate regarding claim results, experience and trends.


The U.S. base salary range for this position is USD 117,000- 184,400.

Actual pay will be determined based upon the individual's skills, experience and location. We strive for market alignment and internal equity with our colleagues' pay.

At AXA XL, we know how important physical, mental, and financial health are to our employees, which is why we are proud to offer benefits such as a competitive retirement savings plan, health and wellness programs, and many other benefits. We also believe in fostering our colleagues' development and offer a wide range of learning opportunities for colleagues to hone their professional skills and to position themselves for the next step of their careers. For more details about AXA XL's benefits offerings, please visit US Benefits at a Glance 2025.

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