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Auto Liability Claims Manager

Location : Charlotte, NC
Job Type : Temp/Contract
Hours : Full Time
Travel : No
Relocation : No

Job Description :

PRIMARY PURPOSE:




To supervise the operation of multiple teams of examiners and technical staff for single or multiple product lines which administer workers compensation and/or general liability claims for clients; to monitor colleagues' workload, 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.




ESSENTIAL FUNCTIONS and RESPONSIBILITIES:



  • Supervises multiple teams of examiners, single of multiple product line examiners and/or several (minimum seven) technical operations colleagues for a wide span of control; may delegate some duties to others within the unit.

  • 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.

  • Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client.

  • 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.

  • Ensures claims files are coded correctly and adequate documentation is made by claims examiners. ADDITIONAL FUNCTIONS and RESPONSIBILITIES • Performs other duties as assigned.

  • Supports the organization's quality program(s). SUPERVISORY RESPONSIBILITIES:

  • Administers company personnel policies in all areas and follows company staffing standards and training recommendations.

  • Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.

  • Provides support, guidance, leadership and motivation to promote maximum performance. WORK ENVIRONMENT: When applicable and appropriate, consideration will be given to reasonable accommodations.


 


Required Qualifications :

Requirements:



  • Thorough knowledge of claims management processes and procedures for multiple product lines

  • Licenses as required

  • Six (6) years claims experience or equivalent combination of education and experience required.

  • Two (2) years claims supervisor experience preferred. 

  • Baccalaureate degree from an accredited college or university preferred.

  • Professional certifications as applicable to line of business preferred.


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