Claims Manager - Tampa, United States - Everspan Group

Description

Job Summary: This role functions as a liaison between the Everspan Claims Department and its business partners (underwriting, MGAs, TPAs, reinsurers, brokers, insureds and claimants) by providing necessary administrative support as well as serving as a back-up resource to the Claims Team in the First Notice of Loss, Payment Processing and other administrative functions as needed.

Primary Duties/Responsibilities:

• Manage and maintain claims email inbox and provide telephone support for claims calls
• Complete claim system transactions as assigned, including new claim set ups (if needed) and triaging new claims to the correct line of business
• Provide daily work oversight in support of Head of Claims and Professional Staff
• Serve as a technical expert for claims and acts as a problems solver for systems and procedural matters
• Assist Management in reviewing existing and future processes to ensure best practices are implemented and followed
• On an ad-hoc basis, support Ambac-Group claims initiatives, including but not limited to advising on claims/TPA diligence and overall claims/TPA operational matters
• Provide training, support and clarification to others as requested
• Work with business partners to ensure the timely processing of information related to insurance policies
• Analyze and validate data to ensure accuracy and quality
• Provide oversight to TPAs and any third party vendors as needed
• Assist in problem solving all clerical processes and coding entries
• Assist in Vendor Payment Allocation and TPA account funding
• Responsible for operational readiness of TPAs
• Assist with coordination of projects and special assignments such as audit preparation
• Access information in response to inquiries from attorneys, brokers, insureds and outside business partners
• Maintain records and complete projects specific to accounts handled by Management
• Gather necessary information compiling ad hoc claims reports
• Maintain panel counsel list and preferred vendor list as directed by Head of Claims
• Monitor and respond to critical business and customer needs in a timely and professional manner
• Ensure establishment of a working electronic data exchange initiatives, including claims bordereaux transmission process
• Import of all TPA bordereaux for evaluation and reconciliation
• Improve quality, simplify processes, and reduce cycle times of claims procedures

Education, Experience, and Other Qualifications:

• Bachelor's degree or equivalent experience
• 5+ years insurance and/or claim handling experience (commercial claims a plus)
• Knowledge of multiple state statutes, including good faith claim handling practices, regulations, and guidelines
• Excellent communications (telephone, e-mail and interpersonal) skills as required
• Exceptional attention to detail and a customer-centric outlook
• Strong analytical and organizational skills
• Software: All Windows operating systems, Microsoft Word, Excel
• Knowledge of various claim systems and claim processing.
• Ability to analyze, think outside the box and build long-standing relationships
• Proven success collaborating with team members at all levels of the organization
• Good sense of timing and the ability to recognize and solve problems
• Ability to prioritize and allocate work actions based on importance, value, urgency and customer needs

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