Director, Claims

2 weeks ago

Austin, United States Keolis North America LLC Full time

Company Description Keolis is a leading provider of passenger transportation services throughout the U.S. and Canada, offering train, bus, and ADA paratransit services. With public contracts coast to coast, we transport millions of people each year. Keolis also provides fleet management and maintenance, logistics, and routing services. (visit www.keolisna.com for official job description. Below is a general overview) Location:

Phoenix, Austin (preferred) or Boston Education Bachelor’s Degree Professional Certifications / Designations such as CIC, ARM, CRMP, CPCU preferred. Knowledge and Experience Experience designing and leading claims management programs Experience in partnering with Legal and Insurers for effective claims litigation management. Financial acumen in liaising on actuarial studies and accrual management Demonstrated knowledge of best practices in risk, insurance, and claims management Experience developing educational materials to communicate / education program stakeholders Knowledge of RMIS systems Proficiency in Microsoft Office Programs- Word, PowerPoint, Excel 7+ yrs of Insurance and Claim Management Skills Process Design / Management and Reporting Strong Customer Service skills and ability to influence others Ability to engage cross functionally in support of strategic business goals Effective communication with multiple levels of the organization including executive leadership as well as with vendors / claimants as needed. Sound decision making skills having practical sense of escalation needs Effective leadership skills with ability to motivate team members / vendors / peers Detail oriented with solid ability to apply analytics to decision making and KPI development Key Accountabilities Claim Process Management Work with location and TPA to ensure effective processes of preservation / collection of all pertinent documentation including videos, recordings, etc. for investigations Partner with TPA to evaluate and develop strategies for prompt resolution Collaborate with In-House Legal with respect to litigated claims and settlement activity Seek and maintain best practice claim management processes (eg, prompt claimant contact, expression of empathy; resolution strategy development; prompt resolution) Interact routinely with internal and external customers Oversee the development of monthly claims reports / analytics. Present to various audiences Meet monthly with TPA for program status, needs, trends, action plan updates, Collaborate extensively with stakeholders related to safety, risk mitigation, and claim reduction Review claim reports and determine defense/development and provide feedback to TPA to develop strategy for resolution taking accident/event severity; known facts and venue Review reserve needs with TPA for appropriateness, presenting changes to the Reserve Committee with justification ensuring approvals in line with delegation of authority. Identify cases to litigate and engage In-House Litigation Attorney on strategy Attend settlement conferences and mediation when necessary Conduct routine claim reviews with business leaders, adjusters, safety, finance, and leadership Conduct post review of all significant resolutions to identify strengths and areas for improvement in the claim management process Insurance Program Management Lead insurance renewal strategy and analysis discussions Oversee development of renewal submissions Innovation Projects Work with external partners, i.e., panel counsel; insurance consultant; vendors as well as internal partners to identify and evaluate process flows, tools etc. to enhance program Utilize Insurance Broker resources to provide 3rd party audits with development of action plans for improvement based on audit results Utilize TPA audit findings to develop process improvement strategies and action plans Support business development in modeling insurance and claims projections for bidding opportunities

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