Description

Under general direction, supervises the investigation, management, and timely disposition of Workers Compensation claims within account, carrier and/or company guidelines, and assists the VP and/or Assistant VP of Claims in managing the Service Center.

• Bachelor's degree or equivalent experience required
• Five or more years of progressive experience as a Claim Examiner, or the equivalent, demonstrating the technical experience in handling or managing longshore or defense base act claims.
• Previous supervisory experience desirable
• Excellent verbal and written communication skills.
• Analytical ability.
• Good mathematical aptitude.
• Good organizational and interpersonal skills.
• Ability to effectively manage, supervise, and develop employees.
• Thorough knowledge of services being delivered by branch office.
• In-depth knowledge of insurance coverages, practices and negotiating skills.
• Familiarity with legal, medical and technical disciplines.
• Industry designations preferred but not required (IIA, AIC, AEI and/or CPCU)
• Where applicable, has passed state licensing requirements for line(s) of insurance handled.
• Settlement Authority: As noted in internal, client and or carrier guidelines.

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• Establishes and communicates performance standards and objectives and conducts performance appraisals. Administers corrective action with regards to any performance deficiencies in line with human resource policies and procedures. Recommends/approves salary adjustments, promotions, transfers and dismissals. Administers all company human resource policies and procedures, communicates to staff, and ensures compliance both for staff and self. Counsels team members on educational and job opportunities which will enhance their career development; keeps staff informed of current trends, changes or new developments in the department and company with periodic meetings.
• Reviews, analyzes, and assigns losses to the appropriate claim examiner with directives. Ensures all directives are executed appropriately. Ensures workloads are balanced and in line with defined staffing models. Makes recommendations to improve productivity and ensure timely closures.
• Reviews files daily to provide instruction for further requirements needed based on best practice standards. Assists with reserve recommendations and approvals. Coaches personnel on investigations, damage/medical evaluations, trains on reserving evaluations and settlement techniques. Ensures staff adheres to both internal and external compliance standards and protocols for large loss reporting guidelines. Attends and prepares staff for claim reviews with clients, carriers and brokers.
• Keeps VP/Assistant Vice President of Claims informed verbally and in writing of activities and problems within assigned area of responsibility; refers matters beyond limits of authority and expertise to VP/Assistant VP of Claims for direction. Performs other related work as required or requested.
• Works within the Risk Tech Claim System and all ancillary systems. Organizes workflows of the Risk Tech Claim System and all ancillary systems to provide maximum productivity. May assist in the training of new and existing staff in the operation and use of the Risk Tech claim system and other various systems.