Claim Account Manager, NAC

Position Responsibilities

• Ensure compliance with all local, federal and state regulations related to claims while minimizing risk/exposure to the Arch organization.
• Provide technical expertise and oversight to TPA adjusters handling workers compensation, auto liability & general Liability claims which also include handling and supervision of outsourced claims.
• Work with our TPA’s to ensure proper claims handling and service delivery, this includes:
• Performing claims oversight on claims with an expected value of over $50,000 for guaranteed cost policies and at 50% of the retention for deductible and self-insured business.
• Attending 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.
• Working 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.).

Candidate Skillset Requirements

• Bachelor's degree preferred.
• 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, multitasking, and time management skills.
• Ability to take part in active strategic discussions.
• Ability to analyze and utilize data to make direct impact on claims outcomes.
• Minimum of ten (12) years’ working experience overseeing and managing multi-line claims including auto liability, general liability, workers’ compensation, products and professional liability for high deductible and self-insured accounts.
• Experience monitoring committee process.
• Proper Adjuster Licenses in all applicable states.
• Ability to handle high severity claims.
• Knowledge & expertise with multiple jurisdictions.
• Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word.
• Ability to work independently and in a team environment.
• Willing and able to travel 25%.