- Minimum of 7-10 claims management experience, including experience with TPA managed claims as well as:
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Head of A&H Claims - Parsippany, United States - AXIS
Description
This is your opportunity to join AXIS Capital – a trusted global provider of specialty lines insurance and reinsurance. We stand apart for our outstanding client service, intelligent risk taking and superior risk adjusted returns for our shareholders. We also proudly maintain an entrepreneurial, disciplined and ethical corporate culture. As a member of AXIS, you join a team that is among the best in the industry.
At AXIS, we believe that we are only as strong as our people. We strive to create an inclusive and welcoming culture where employees of all backgrounds and from all walks of life feel comfortable and empowered to be themselves. This means that we bring our whole selves to work.
All qualified applicants will receive consideration for employment without regard to race, color, religion or creed, sex, pregnancy, sexual orientation, gender identity or expression, national origin or ancestry, citizenship, physical or mental disability, age, marital status, civil union status, family or parental status, or any other characteristic protected by law. Accommodation is available upon request for candidates taking part in the selection process.
AXIS is seeking a Head of A&H Claims to join our North America Claims team reporting to the Head of TPA & Programs. As the Head of Accident and Health Claims, you'll oversee all aspects of the claims process related to accident and health insurance policies. This includes managing a team responsible for overseeing Third-Party Administrators (TPAs), ensuring compliance with regulations, as well as fair claims processing. You'll also be responsible for developing and implementing strategies to improve efficiency, reduce fraud, and enhance customer satisfaction. Additionally, you'll collaborate with other departments, such as underwriting and risk management, to ensure effective claims management practices. Strong leadership, analytical skills, and knowledge of insurance regulations are essential for this role.
• Direct management of A&H Claims – both active and runoff -including the investigation, analysis and evaluation of coverage liability, within best practices
• Direct management of Third-Party Administrator (TPA) handled A&H claims, both active and runoff, including the investigation, analysis and evaluation of coverage liability within best practices
• Building and maintaining key relationships with internal stakeholders (e.g., peers, Underwriting, Actuarial, various executive management leaders) and external stakeholders (e.g., brokers, insureds, attorneys, auditors, reinsurers, and vendors)
• Coordinating with the Head of TPA & Program Claims, to deliver best in class TPA handled claims over of all lines of AXIS Accident & Health business including but not limited to:
o Managing costs, continuously improve operations, develop and enhancement of the TPA and vendors
o Managing relationships with TPAs through all necessary stages (onboarding, offboarding and run-off), due diligence, contract review, negotiation, and tracking in collaboration with internal and external stakeholders
• Managing AXIS and TPA claims teams with respect to audits and post-audit Management Action Plans (MAP)
• Maintain guidelines, practices and procedures and benefit clarifications for Accident & Health Claims.
• Actively participate and recommend appropriate edits in review of but not limited to policy templates, brochures, id cards, claim forms and other fulfillment documents.
• Collaborating across disciplines and business units.
• Identifying trends and issues with both individual and portfolio impact and formulating the processes and strategies for handling such claims as well as ensuring accurate and consistent claims management across impacted underwriting segments and lines of business.
• Actively coaching and mentoring direct reports, providing regular feedback, and developing employees for broader roles and responsibilities that support professional growth and development.
• Mentoring and team development with strong leadership skills.
• Extensive communication with senior executives, brokers, reinsurers, actuaries, insureds, and auditors (both external and internal)
KEY SKILLS & ABILITIES:
• Demonstrated leadership, organizational, and management skills.
• Investigates potentially fraudulent claims and take appropriate action.
• Makes recommendations for coverage/settlement/disposition of claims.
• Demonstrated ability to influence and collaborate at all organizational levels, both internally and externally as well as the ability to identify and resolve complex issues
• Analytical thinker that can drive results using all facets of the processes
• Understanding of and ability to balance both the immediate claim issues as well as the broader portfolio impact and customer service impact of coverage disputes and issues
• Excellent oral and written communication skills with the ability to deal effectively with people with conflicting expectations, differing opinions, and multiple viewpoints
For this position, we expect to offer a base salary in the range of USD 170K - 230K. The specific salary offer will be based on an assessment of a variety of factors, including the experience of the successful candidate and their work location. In addition, all employees are eligible for competitive incentive targets, with awards based on overall corporate and individual performance. On top of this, we offer a comprehensive and competitive benefits package which includes medical plans for employees and their families, health and wellness programs, retirement plans, tuition reimbursement, paid vacation, and much more.
