Claims Team Lead - General Liability | Jurisdiction: LA | Licensing: LA | Dedicated Account - Remote (Must reside in LA)

PRIMARY PURPOSE OF THE ROLE:

To supervise the operation of multiple teams of examiners and technical staff for liability claims for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims.

• Supervises multiple teams of examiners, multiple product line examiners and/or several (minimum seven) technical operations colleagues for a wide span of control;
• Identifies and advises management of trends, problems, and issues as well as recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the office.
• Provides technical/jurisdictional direction to examiner reports on claims adjudication.
• Compiles reviews and analyzes management reports and takes appropriate action.
• Performs quality review on claims in compliance with audit requirements, service contract requirements, and quality standards.
• Acts as second level of appeal for client and claimant issues regarding claim specific, procedural or special requests; implements final disposition of the appeal.
• Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner.
• Maintains contact with the client on claims and promotes a professional client relationship; makes recommendations to client as suggested by the claim status; and provides written resumes of specific claims as requested by client.
• Assures that direct reports are properly licensed in the jurisdictions serviced.
• Safeguards claims files are coded correctly and adequate documentation is made by claims examiners.

Qualifications

• Education & Licensing: High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.
• Experience: Six (6) years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.
• Licensing / Jurisdiction Knowledge: TAKING CARE OF YOU

Work Environment Requirements

• Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
• Physical: Computer keyboarding, travel as required
• Auditory/Visual: Hearing, vision and talking