Description:

POSITION SUMMARY

Work directly with regional Claims Managers to supervise employees in the assigned claims office. This includes assisting with recruiting, hiring and management of required staff. Supervise, evaluate, train, discipline and support staff. Ensure that supervised staff follows policies and procedures to ensure company compliance with regulatory standards, company policies and procedures, and best practices. Assist the manager in the day to day operations of the assigned office.

RESPONSIBILITIES

Monitor the production and measure the performance of claims staff for full compliance with procedure manual and adopted best practices. Assign new claims and when necessary transfer existing claims to appropriate adjusters based on expertise of adjuster. Assist claims manager with training in claims related topics. Address claims related concerns and issues directly with the claims manager. Complete regular claim reviews for each assigned employee and address any concerns that may be identified, including but not limited to: timely determinations, accurate calculations of wages and benefits, statutory and regulatory compliance, reserve adequacy, subrogation, claim investigations, surveillance, litigation management, subsequent injury fund, reinsurance/excess insurance reporting and assist adjusters in addressing all topics. Assist in the development and implementation of work performance standards for claims adjusters. Ensure claims adjusters are responding to telephone calls, e-mails and correspondence timely and effectively. Complete annual performance evaluations of each assigned adjuster in accord with adopted procedures and best practices. Work directly with clients, brokers, agents, and employers in the explanation of claims related services for policy holders. When required, work directly with state regulators to address claims questions, complaints, and audits to ensure full compliance with applicable laws, regulations and directives from the regulator(s). Timely address concerns with injured workers, medical providers and employers. Other related assignments as assigned. Eligible for hybrid work arrangement.

Requirements:

QUALIFICATIONS

High school diploma or GED required Bachelor's degree or equivalent experience preferred Minimum of 5 years claims management experience. 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