Claims Account Manager, National Accounts Casualty

4 days ago

Jersey City, New Jersey, United States Arch Insurance Group Full time

Job Summary

The Claims Division is seeking a team member to join the National Accounts Casualty (NAC) Team as a Sr. Claims Account Manager. (CAM). In this role, the responsibilities include but not limited to actively manage and effectively oversee assigned NAC business accounts for Workers Compensation, Auto, and General Liability claims written on a guaranteed cost basis, high deductible, and self-insured retention basis handled by third party administrators.

Responsibilities

  • Work with our TPA's to ensure proper claims handling and service delivery, which includes:
  • Performing claims oversight on claims with an expected value over $50,000 for guaranteed cost policies and at 50% of the retention for deductible and self insured business
  • Attend 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
  • Work 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.)

Education and Experience

  • Bachelor's degree preferred
  • Minimum of ten (10) years' working experience overseeing and managing multi-line claims with workers' compensation and auto/general liability; preferred 15+ years
  • 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
  • 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, and time management skills
  • Ability to take part in active strategic discussions
  • Ability to work independently and in a team environment
  • Willing and able to travel 25%

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