Senior Claims Specialist - TPA Liability

About the role

Active management of caseload of high-value liability claims venue throughout the United States for assigned clients in our US Risk Management, Construction, Programs and other supported business units.

Effectively coordinate coverage referrals and compliance related issues with Third Party Administrators (TPAs), Claim Management and our Compliance Department.

Conduct claims handling and oversight of TPAs in accordance with AXA XL best practices in the major phases of claim handling including coverage, investigation, evaluation, reserving, recovery, and resolution.

Provide oversight, guidance and direction to TPA claim adjusters on all major phases of claim handling including coverage, investigation, evaluation/reserving, recovery, and resolution.

Collaborate with business partners, as appropriate, on claim management and strategy to help deliver the most optimal outcome and ensure, to the extent possible, that we are in alignment on our evaluation of the exposure and strategy to resolve.

Collaborate and consult with internal claim resources such as regional practice leaders and claim legal to ensure the most optimal outcome and mitigate claim expense.

Perform Claim Account Management for assigned clients to communicate claim issues and results, participate in the TPA audit process, and collaborate on technical and service issues relating to the TPA performance and the client.

Collaborate proactively with internal and external stakeholders regarding claim experience, results, and trends (e.g. actuarial, reinsurance, credit risk and underwriting).

Provide input into the development of key metrics to support Claim Audits and assist in the coordination and retention of external counsel, as needed.

Responsibilities

• Active management of caseload of high-value liability claims venue throughout the United States for assigned clients in our US Risk Management, Construction, Programs and other supported business units.
• Effectively coordinate coverage referrals and compliance related issues with Third Party Administrators (TPAs), Claim Management and our Compliance Department.
• Conduct claims handling and oversight of TPAs in accordance with AXA XL best practices in the major phases of claim handling including coverage, investigation, evaluation, reserving, recovery, and resolution.
• Provide oversight, guidance and direction to TPA claim adjusters on all major phases of claim handling including coverage, investigation, evaluation/reserving, recovery, and resolution.
• Collaborate with business partners, as appropriate, on claim management and strategy to help deliver the most optimal outcome and ensure, to the extent possible, that we are in alignment on our evaluation of the exposure and strategy to resolve.
• Collaborate and consult with internal claim resources such as regional practice leaders and claim legal to ensure the most optimal outcome and mitigate claim expense.
• Perform Claim Account Management for assigned clients to communicate claim issues and results, participate in the TPA audit process, and collaborate on technical and service issues relating to the TPA performance and the client.
• Collaborate proactively with internal and external stakeholders regarding claim experience, results, and trends (e.g. actuarial, reinsurance, credit risk and underwriting).
• Provide input into the development of key metrics to support Claim Audits and assist in the coordination and retention of external counsel, as needed.

Requirements

• Advanced claim handling experience involving high value/complex claim management and litigation management.
• Defined expertise in managing coverage and compliance related issues.
• Multi-jurisdictional (U.S.) experience.
• Demonstrated expertise in designated line(s) of business: Automobile, Construction, and General Liability.
• Experience managing claims in an unbundled insurance model.
• Experience with NY Labor Law desired.

Qualifications

• Leadership: Demonstrates managerial courage and ability to influence actions of external relationships. Coaches, sets expectations, evaluates and holds people accountable for delivering.
• Effective communication and negotiation skills: Excellent verbal and written communication, and negotiation skills.
• Effective organizational and time management skills.
• Strategic thinking: Exhibit ownership to look for ways to continuously improve internal processes as it relates to improving claim outcomes and managing the performance of external relationships.
• Effective teamwork/collaboration skills in order to effectively collaborative with Regional Practice Leads, Claim Legal, TPA and clients to produce desired outcomes, as well as with other internal and external stakeholders such as, brokers, actuarial, reinsurance and business partners to communicate regarding claim results, experience and trends.

Skills

• Advanced claim handling experience involving high value/complex claim management and litigation management.
• Defined expertise in managing coverage and compliance related issues.
• Multi-jurisdictional (U.S.) experience.
• Demonstrated expertise in designated line(s) of business: Automobile, Construction, and General Liability.
• Experience managing claims in an unbundled insurance model.
• Experience with NY Labor Law desired.

Benefits

Inclusion: AXA XL is committed to equal employment opportunity and will consider applicants regardless of gender, sexual orientation, age, ethnicity and origins, marital status, religion, disability, or any other protected characteristic. At AXA XL, we know that an inclusive culture and enables business growth and is critical to our success. That’s why we have made a strategic commitment to attract, develop, advance and retain the most inclusive workforce possible, and create a culture where everyone can bring their full selves to work and reach their highest potential.

Sustainability: At AXA XL, Sustainability is integral to our business strategy. In an ever-changing world, AXA XL protects what matters most for our clients and communities. We know that sustainability is at the root of a more resilient future. Our 2023-26 Sustainability strategy, called “Roots of resilience”, focuses on protecting natural ecosystems, addressing climate change, and embedding sustainable practices across our operations.

Pay

The U.S. base salary range for this position is USD 117,000- 184,400. Actual pay will be determined based upon the individual’s skills, experience and location. We strive for market alignment and internal equity with our colleagues’ pay.

Schedule

N/A