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Complex Claims Director
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Claims Operations Director
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ASSOCIATION HEALTH CARE MANAGEMENT Dallas, United StatesJob DescriptionJob Description · Association Health Care Management is seeking an experienced Claims Operations Director in Adjudicating Claims to join our team in Dallas, TX · Competitive Pay & Benefits · MUST have TPA experience · A Great Company Culture & Team Atmosphere T ...
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AVP, Executive Claim Director
2 weeks ago
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Property Damage Claims Director
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Property Damage Claims Director
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Property Damage Claims Director
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Director, E&O Claims
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Corporate Paralegal
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Director, E&O Claims
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Corporate Paralegal
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Director, E&O Claims
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Corporate Paralegal
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Liability Claims Analyst
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Liability Claims Program Manager
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Regional Director of Clinical Operations
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Liability Claims Analyst
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Liability Claims Analyst
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Liability Claims Analyst
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Liability Claims Analyst
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Director, Program Business
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AVP, Executive Claim Director - Dallas, United States - Chubb
Description
Job DescriptionChubb is currently seeking an Assistant Vice President, Executive Claim Director for our Central Region.This is a work-from-the-office position requiring all candidates to work from the Chicago office a minimum of 3 days per week.
Claim Diary:
Direct handle a diary of up to 35-50 complex claims that involve medical/indemnity severity, jurisdictionally complex litigation, sensitive account exposures etc.
Maintain a Consultative diary of complex claims at the direction of the Regional Discipline Managers (RDM).Partner with the supervisor and adjuster to provide technical direction, develop management/resolution strategies that maximize claim outcomes, provide authority when warranted.
Technical Case Management/Support:
At the Regional Discipline Managers direction, provide support to drive technical consistency within the region that results in quality claim outcomes and superior customer service: Oversee the Claim Committee process.
Implement protocols that ensure appropriate claims are identified, attendee notifications and materials are prepared in advance, presenters are prepared, appropriate authority level is present.
Serve as meeting leader to facilitate/co-ordinate effective/efficient committee meetings.Serve as senior resource to review/roundtable litigation appeals (below case law level) to evaluate if continued litigation is warranted, potential for success, alternative resolutions, etc.
Timely escalate appeal cases with the potential for case law to WC Claim and Technical Officers. Drive consistency in regions approach to appellate pursuits. In coordination with Region Discipline Manager, serve as a Point of Contact for claims escalation within the region. Support RDM with Account Management issues to bring senior technical expertise to expedite issue resolution.When warranted, assist RDM to identify region financial trends, provide insight into Action Plans and support implementation to meet established financial goals.
Identify region training needs through consultative oversight and Claim Committee management. Escalate needs and partner with RDM/Tower Technical Officer to develop/implement training plans.Matrix Technical Support to Tower Technical Officer:
Partner with tower Technical Officer to serves as the region's jurisdictional subject matter expert (SME) resource and special project coordinator: Serve as the region's local Project Lead for countrywide project implementations to ensure successful, consistent execution of project deployments.
Participate in project development meetings to represent the region's needs and work with regional peers to support a holistic approach to deployments.
Partner with Technical Officer when warranted to research statutory rules, compliance regulations, legislative changes, etc. to determine the impact to the regions workflows/processes and exposure changes to the claim book.Support the Technical Officer on exposure assessments for Large Losses and other significant events (multiple claimant severity event, unique insured exposure, etc.) to report to business partners.
Work closely with Technical Officer and RDM to analyze Best Practice Closed File Review results and serve as a champion to support development and implementation of action plans for warranted changes/improvements Technical Skills & Competencies:Strong proficiency in all areas of Workers' Compensation claims adjusting High level of accuracy with claim financials: benefit/bill payment, coding, reserves, and inventory management and then impact of claims transactions on customers Advanced understanding of Claim Best Practices and Business Analytics Ability to incorporate analytical data into team management Exceptional negotiation skills and resources that will influence team results Strong business acumen and understanding of the fundamental components of Claims, Underwriting, agency relationships, industry strategies and trends Extensive knowledge of insurance contracts, investigation techniques, legal requirements, and insurance regulation Exceptional oral, written, and presentation skills that positively influence a wide audience within and outside the Claim department Ability to promote open communication that fosters an environment of continual learning, staff development and team collaboration Track record of success in coaching and developing staff An ability to be flexible, imaginative and to work well in teams Exceptional organizational, prioritization and time management capabilities Innovative thinker with ability to multi-task, plan, and delegate appropriately Experience, Education & Requirements: Minimum 10+ years of experience in handling Workers' Compensation claims Ability to handle claims in multiple jurisdictions and within compliance standards AIC, RMA or CPCU completed coursework or designation(s) are a plus.
College Degree preferred.If you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure.
Qualifications for Internal Candidates Chubb is currently seeking an Assistant Vice President, Executive Claim Director for our Central Region.This is a work-from-the-office position requiring all candidates to work from the Chicago office a minimum of 3 days per week.
Claim Diary:
Direct handle a diary of up to 35-50 complex claims that involve medical/indemnity severity, jurisdictionally complex litigation, sensitive account exposures etc.
Maintain a Consultative diary of complex claims at the direction of the Regional Discipline Managers (RDM).Partner with the supervisor and adjuster to provide technical direction, develop management/resolution strategies that maximize claim outcomes, provide authority when warranted.
Technical Case Management/Support:
At the Regional Discipline Managers direction, provide support to drive technical consistency within the region that results in quality claim outcomes and superior customer service: Oversee the Claim Committee process.
Implement protocols that ensure appropriate claims are identified, attendee notifications and materials are prepared in advance, presenters are prepared, appropriate authority level is present.
Serve as meeting leader to facilitate/co-ordinate effective/efficient committee meetings.Serve as senior resource to review/roundtable litigation appeals (below case law level) to evaluate if continued litigation is warranted, potential for success, alternative resolutions, etc.
Timely escalate appeal cases with the potential for case law to WC Claim and Technical Officers. Drive consistency in regions approach to appellate pursuits. In coordination with Region Discipline Manager, serve as a Point of Contact for claims escalation within the region. Support RDM with Account Management issues to bring senior technical expertise to expedite issue resolution.When warranted, assist RDM to identify region financial trends, provide insight into Action Plans and support implementation to meet established financial goals.
Identify region training needs through consultative oversight and Claim Committee management. Escalate needs and partner with RDM/Tower Technical Officer to develop/implement training plans.Matrix Technical Support to Tower Technical Officer:
Partner with tower Technical Officer to serves as the region's jurisdictional subject matter expert (SME) resource and special project coordinator: Serve as the region's local Project Lead for countrywide project implementations to ensure successful, consistent execution of project deployments.
Participate in project development meetings to represent the region's needs and work with regional peers to support a holistic approach to deployments.
Partner with Technical Officer when warranted to research statutory rules, compliance regulations, legislative changes, etc. to determine the impact to the regions workflows/processes and exposure changes to the claim book.Support the Technical Officer on exposure assessments for Large Losses and other significant events (multiple claimant severity event, unique insured exposure, etc.) to report to business partners.
Work closely with Technical Officer and RDM to analyze Best Practice Closed File Review results and serve as a champion to support development and implementation of action plans for warranted changes/improvements Technical Skills & Competencies:Strong proficiency in all areas of Workers' Compensation claims adjusting High level of accuracy with claim financials: benefit/bill payment, coding, reserves, and inventory management and then impact of claims transactions on customers Advanced understanding of Claim Best Practices and Business Analytics Ability to incorporate analytical data into team management Exceptional negotiation skills and resources that will influence team results Strong business acumen and understanding of the fundamental components of Claims, Underwriting, agency relationships, industry strategies and trends Extensive knowledge of insurance contracts, investigation techniques, legal requirements, and insurance regulation Exceptional oral, written, and presentation skills that positively influence a wide audience within and outside the Claim department Ability to promote open communication that fosters an environment of continual learning, staff development and team collaboration Track record of success in coaching and developing staff An ability to be flexible, imaginative and to work well in teams Exceptional organizational, prioritization and time management capabilities Innovative thinker with ability to multi-task, plan, and delegate appropriately Experience, Education & Requirements: Minimum 10+ years of experience in handling Workers' Compensation claims Ability to handle claims in multiple jurisdictions and within compliance standards AIC, RMA or CPCU completed coursework or designation(s) are a plus.
College Degree preferred.If you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure.
About UsChubb is a world leader in insurance.With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients.
The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.
At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it.Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law.
Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees. Chubb prohibits all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment.