Claims Team Lead, Auto

About the role

Supervise the operation of multiple teams of examiners and staff for liability claims for clients. Monitor colleagues' workloads, provide training, and oversee individual claim activities. Offer technical and jurisdictional direction to examiner reports on claims adjudication. Maintain a diary on claims, including frequent updates on complex or high-exposure claims.

Responsibilities

• Supervise multiple teams of examiners, product line examiners, and/or technical operations colleagues (minimum seven) with a wide span of control; delegate duties as needed.
• Identify and advise management of trends, problems, and issues, recommending courses of action; inform management of new procedures and ideas for continuous process improvement.
• Provide technical and jurisdictional direction to examiner reports on claims adjudication.
• Compile, review, and analyze management reports, taking appropriate action.
• Perform quality reviews on claims to ensure compliance with audit requirements, service contract requirements, and quality standards.
• Act as the second level of appeal for client and claimant issues regarding claim-specific, procedural, or special requests; implement final disposition of appeals.
• Review reserve amounts on high-cost claims and claims exceeding the examiner’s authority.
• Monitor third-party claims; maintain periodic reviews of litigated claims, serious vocational rehabilitation claims, questionable claims, and sensitive claims as determined by the client.
• Maintain contact with clients on claims, fostering professional relationships; provide recommendations and written resumes of specific claims as requested.
• Ensure direct reports are properly licensed in the jurisdictions serviced.
• Verify claims files are coded correctly and adequately documented by claims examiners.
• Support the organization’s quality program(s).
• Perform other duties as assigned.

Supervisory Responsibilities

• Administer company personnel policies and follow staffing standards and training recommendations.
• Interview, hire, and establish colleague performance development plans; conduct performance discussions.
• Provide support, guidance, leadership, and motivation to promote maximum performance.

Requirements

• Bachelor’s degree from an accredited college or university preferred.
• Required licenses and professional certifications applicable to the line of business.
• Six (6) years of claims experience or equivalent combination of education and experience, including two (2) years of claims supervisor experience.

Skills & Knowledge

• Thorough knowledge of claims management processes and procedures for multiple product lines.
• Excellent oral and written communication, including presentation skills.
• PC literate, including proficiency in Microsoft Office products.
• Leadership and management skills.
• Analytical and interpretive skills.
• Ability to work in a team environment.
• Ability to meet or exceed performance competencies.

Work Environment

• Physical: Computer keyboarding.
• Auditory/Visual: Hearing, vision, and talking.
• Mental: Clear and conceptual thinking ability; excellent judgment and discretion; ability to meet deadlines.