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Senior Claims Manager

4 weeks ago

Melville, New York, United States Chubb Full time
Job Title: Senior Claims Manager

Chubb is seeking an experienced Senior Claims Manager to lead a team of professional healthcare liability claims adjusters. This hybrid position requires 3 days in the office and 2 days working from home.

Key Responsibilities:
  • Supervise a claims team of professionals and assign new claims with direction to the claims professional.
  • Maintain a diary system to ensure each file is reviewed at a minimum of every 90 days.
  • Provide coaching and feedback to direct reports and develop, work, and share performance and productivity goals.
  • Review, analyze, and share performance results, productivity, and audit/quality review results.
  • Work with claims professionals to prepare detailed 90-day Claim Summary Reports and provide updates to the client on investigation, potential settlement opportunities, claim denials, reservation of rights, third-party tenders, and recommendations to present at claims review meetings.
  • Post loss and expense reserves in the Claims system within authority limits and recommend reserve changes above authority to AVP and/or VP of Claims.
  • Review progress and status of medical malpractice claims with claims leadership and discuss issues/opportunities/task and remedial actions.
  • Prepare and submit to claims leadership all unusual or potentially undesirable exposures such as allegations of bad faith or unfair claim practice allegations.
  • Assist Claims Leadership in formulating improvements in claims handling procedures.
  • Assist and work with Partnership Leaders on delivering results, attend meetings, and claim reviews.
  • Review and confirm claims professionals have secured the appropriate releases, proofs of loss, or compensation agreements and issue company drafts in payments for claims.
  • Maintain claims with the appropriate file notes, reports, photos, and documentation within the claim.
  • Follow all company and regulatory compliance requirements.
  • Update claim timely with Medicare data and address Medicare reporting & interest.
  • Meet or exceed performance goals.
Qualifications:
  • 10 or more years of experience as a claim professional and/or claims management with a high degree of specialized and technical competence in the handling of professional and general liability claims with emphasis on hands-on file and litigation management.
  • P&C insurance adjuster license where required.
  • Knowledge of insurance industry and claims handling concepts, practices, and procedures.
  • Strong background and demonstrated ability in dealing with significant coverage matters.
  • An understanding of the tenants of insurance and legal principles.
  • Knowledge of P&C Group coverage and services.
  • Working knowledge of industry best practices and procedures.
  • An ability to work independently.
  • Excellent interpersonal communications and negotiation skills and an ability to deal with customers and business partners in a professional manner.
  • Ability to make prompt, reasoned decisions based upon detailed analysis of complex issues.
  • Bachelor's Degree or higher. JD preferred.

Chubb offers a comprehensive benefits package, including a pay range of $80,500 to $158,000, and a discretionary annual incentive program. This role may also be eligible to participate in a discretionary annual incentive program. ESIS, a multi-line Third-Party Administrator (TPA), provides claims, risk control & loss information systems to Fortune 1000 clients across its North American platform. ESIS provides a full range of sophisticated risk management services, including workers compensation claims handling; a broad spectrum of casualty insurance products, such as general liability, automobile liability, products liability, professional liability, and medical malpractice claims handling; and disability management. ESIS Specialty continually monitors, measures, and analyzes trends while working closely with clients to identify opportunities to positively impact their program costs. ESIS Specialty applies a balanced approach to claims handling and management and continually refines approach to be sure services are customized, complementary, and complete. Chubb is a world leader in insurance, with operations in 54 countries, providing commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients. At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law. Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop, and retain employees. Chubb prohibits all unlawful discrimination, harassment, and retaliation against any individual who reports discrimination or harassment.