Operate as the lead point of contact for any and all matters specific to clients. Equitable and accurate claims processing and settlement value in a manner consistent with client expectations and which contributes to the profitability of the company. Must be located in New Jersey or contiguous to New Jersey as attendance at client and company meetings in New Jersey is required.
- Effectively supervise, lead, motivate, and provide direction to a workers' compensation unit adjusters and support staff.
- Accept, review, provide initial handling recommendations and distribute new claims as they come into the unit.
- Provide guidance to staff on coverage and damage analysis, especially on severe and complex claims.
- Provide oversight of all staff claims handling activities, including pursuit of subrogation, third party recoveries and application of credits and offsets.
- Conduct and oversee all internal claim reviews and audits to ensure effective claims handling by adjusters.
- Oversee ongoing training, development, and supervision of claims unit to ensure clearly defined responsibilities and standard performance.
- Attend court-related conferences, depositions, mediations, arbitrations, and other meetings as needed.
- Review time tracking and approve time off requests to ensure adequate staffing at all times.
- Evaluate staff performance on an ongoing basis; responsible for performance reviews, goal setting and progressive discipline procedures to ensure a non-discriminatory and consistent work force.
- Attend external client meetings to present claims for settlement authority and conduct claim and program reviews.
- Manage clients in the areas of claims administration and litigation through benchmarking, loss analysis and general performance measurement reports to ensure adherence to Best Practices, as well as company client specific claim program goals, directives, initiatives, policies and procedures.
- Take primary responsibility in drafting company responses to Proposals, RFQs/RFPs and/Contracts. Annually evaluate client contracts for cost savings and potential increases.
- Provide all client related documents to appropriate staff and departments, including: client contact lists, coverage documents, risk management plans, client meeting schedule, defense panel list and authorized billing rates, excess reporting requirements, account protocols, changes to protocols and any other pertinent information needed to manage account.
- Identify and take corrective actions for client concerns working with appropriate Claim Managers/Supervisors and other internal staff.
- Conduct or participate in client training and education externally as
- Maintain a thorough knowledge and understanding of laws and maintain current knowledge on revisions or changes in the law; applies to policies and procedures appropriately.
- Travel on behalf of client, where needed.
- Attend state and national insurance and risk management conferences when requested or required by Upper. Management.
- Perform other duties as required
Qualifications
- Associate's or Bachelor's degree, or equivalent experience
- 10 years insurance/TPA claims experience
- 5 years managerial experience
- 6+ years minimum Property & Casualty insurance experience preferred
- Ability to work independently
- Exceptional technical abilities
- SKILLS: Proficient with MS Excel and Word; computer experience with related claims software; excellent verbal and written communication skills; proven interpersonal skills capable of dealing with all levels of personnel; exceptional ability to multi-task; excellent negotiation skills; superior organizational and decision making skills; customer-focused orientation; strong analytical and strategizing skills; expertise in Property and Casualty and related claims handling practices and ability to apply same; deep knowledge of client and carrier claims procedures; significant understanding of self-insured retention, excess and reinsurance reporting; deep understanding of claims evaluations and exposure potential; fluent in medical terminology and medical/injury treatments. Must possess outstanding customer service skills to interact effectively with clients, defense counsel, vendors, management, and subordinates. Must have expertise in principles of workers' compensation law and applicable state and federal laws, including CMS and Medicare laws. Must have proven expertise in litigation management.
Benefits
We're committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. Benefits eligibility may differ depending on full-time or part-time status. Compensation depends on the applicable US geographic market. The expected base pay for this position ranges from $90,000 - $110,000 annually, and will be based on a number of additional factors including skills, experience, and education.
