Description
The Claims Division is seeking a team member to join the National Accounts Casualty (NAC) Team as a Claims Account Manager. (CAM). In this role, the responsibilities include but not limited to actively manage and effectively oversee assigned NAC business accounts for Workers Compensation, Auto, and General Liability claims written on a guaranteed cost basis, high deductible, and self-insured retention basis handled by third party administrators.
Responsibilities
Work with our TPA’s to ensure proper claims handling and service delivery, which includes:
Performing claims oversight on claims with an expected value over $50,000 for guaranteed cost policies and at 50% of the retention for deductible and self-insured business
Attend mediations and trials
Granting reserve and settlement authority on cases above the TPA’s authority
Making coverage determinations and writing Reservation of Rights and coverage disclaimer letters
Completing claims audits at TPA branch claims offices or online
Handling or facilitating administrative tasks between Arch and the TPA to ensure seamless service delivery to the client
Act as the Service Manager/Arch claims contact for all accounts written by NAC, which includes:
Participating in client set-up meetings
Participating in telephonic as well as in person claims reviews
Participating in mid-term meetings
Helping to resolve any claims or service issues that arise
Work with Underwriting and Risk Control to assist in the risk selection process, which includes:
Reviewing new/renewal submissions and commenting on any claims, legal or jurisdictional issues
Addressing potential solutions to current claims or service problems
Participating in meetings with brokers and/or prospective accounts
Identifying loss trends on an account or book of business level
Conducting due diligence reviews on new TPA’s or accounts that want to self-administer claims
Collaborate with other internal business units such as Finance, IT and Legal on any issues or projects that arise
Address state and federal regulatory issues (Medicare issues, state insurance department audits/complaints, state workers compensation board requirements, etc.)
Experience & Required Skills
Minimum of ten (10) years’ working experience overseeing and managing multi-line claims with workers’ compensation and auto/general liability.
Demonstrate the ability to handle high severity claims
Intermediate knowledge & expertise with multiple jurisdictions
Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word
Exceptional communication (written and verbal), influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines
Strong problem-solving, analytical, organizational, and time management skills
Demonstrate the ability to take part in active strategic discussions
Demonstrate the ability to work independently and in a team environment
Willing and able to travel 25%
Education
Bachelor's degree preferred in lieu of degree 15 years of direct experience with claims oversight of multi-line claims with workers' comp, auto, GL.
Proper Adjuster Licenses in all applicable states
