Claims Team Leader

2 weeks ago


Dallas, Texas, United States Broadspire Full time

Commitment to Excellence

Position Overview

Under general supervision, oversees the investigation, management, and prompt resolution of Workers Compensation claims in accordance with account, carrier, and company standards. Collaborates with the VP and/or Assistant VP of Claims to effectively manage the Service Center.

Key Responsibilities

  • Establishes and communicates performance benchmarks and objectives, conducting regular performance evaluations.
  • Administers corrective actions regarding performance issues, aligning with human resource policies and procedures.
  • Recommends and approves salary adjustments, promotions, transfers, and terminations.
  • Implements all company human resource policies, ensuring compliance for both staff and self.
  • Guides team members on educational and career advancement opportunities, keeping them informed of industry trends and departmental changes through regular meetings.

Reviews, analyzes, and allocates claims to the appropriate examiners with clear directives, ensuring all instructions are executed effectively. Balances workloads in accordance with established staffing models and recommends strategies to enhance productivity and ensure timely claim closures.

Conducts daily file reviews to provide guidance on additional requirements based on best practices. Assists with reserve recommendations and approvals, coaching staff on investigations, evaluations, and settlement techniques. Ensures adherence to both internal and external compliance standards for large loss reporting.

Maintains open communication with the VP/Assistant VP of Claims regarding activities and challenges within the assigned area, referring complex matters for further direction. Performs additional related duties as necessary.

Operational Responsibilities

Utilizes the Risk Tech Claim System and associated platforms to maximize productivity. May assist in training new and existing personnel on the operation and utilization of the Risk Tech claim system and other relevant systems.

Qualifications

  • Bachelor's degree or equivalent experience is required.
  • A minimum of five years of progressive experience as a Claim Examiner or equivalent, demonstrating the ability to manage complex cases with significant judgment and discretion.
  • Previous supervisory experience is preferred.
  • Industry designations such as IIA, AIC, AEI, and/or CPCU are advantageous but not mandatory.
  • Must meet state licensing requirements for the relevant lines of insurance.

Skills and Competencies

  • Continuous interaction with adjusters, claimants, and clients to facilitate information exchange; decisions may require analysis of various alternatives.
  • Exceptional verbal and written communication skills.
  • Strong analytical abilities and mathematical aptitude.
  • Excellent organizational and interpersonal skills.
  • Proven ability to effectively manage, supervise, and develop team members.
  • Comprehensive knowledge of services provided by the branch office.
  • In-depth understanding of insurance coverages, practices, and negotiation skills.
  • Familiarity with legal, medical, and technical disciplines.

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