Claims and Litigation Manager - Atlanta

Job summary

Responsibilities include providing strategic oversight of all property and liability claims processed by the third-party administrator (TPA), directing TPA on assignment of defense counsel, overseeing selection and performance of claims-related vendors, evaluating TPA work product and processes to ensure proper claims handling, monitoring claim reserves plans of action detailed status reports assessing TPA performance through audits file reviews reports metrics compliance with service-level agreements reviewing new claims for coverage conflicts preparing issuing notices reservation rights collaborating outside coverage counsel resolve document claims-related coverage concerns assisting TPA legal counsel expediting closure claims approving high-exposure complex non-routine decisions settlements settlements properly executed consideration Medicare Set Aside Agreements overseeing litigated cases in collaboration assigned defense counsel review evaluate litigation plans budgets strategies file handling alignment program goals monitor work product compliance established litigation management guidelines request filing pre-answer motions assist settlement negotiations participating negotiation directly claimants behalf GIRMA participating defense counsel litigated cases attending depositions mediations hearings trial preparation meetings serving liaison members questions concerns escalated issues facilitating communication between TPA defense counsel members addressing problems concerns scheduling performing new member orientation conducting onsite visits members discuss strategy strengthen relationships educating members coverage processes best practices incident reporting documentation maintaining thorough documentation reporting decision-making accountability

Job description