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Sr Claims Case Manager

2 weeks ago

Plymouth Meeting, Pennsylvania, United States PECO Full time $83,200 - $114,400 per year

Who We Are
We're powering a cleaner, brighter future.

Exelon is leading the energy transformation, and we're calling all problem solvers, innovators, community builders and change makers. Work with us to deliver solutions that make our diverse cities and communities stronger, healthier and more resilient.

We're powered by purpose-driven people like you who believe in being inclusive and creative, and value safety, innovation, integrity and community service. We are a Fortune 200 company, 19,000 colleagues strong serving more than 10 million customers at six energy companies -- Atlantic City Electric (ACE), Baltimore Gas and Electric (BGE), Commonwealth Edison (ComEd), Delmarva Power & Light (DPL), PECO Energy Company (PECO), and Potomac Electric Power Company (Pepco).

In our relentless pursuit of excellence, we elevate diverse voices, fresh perspectives and bold thinking. And since we know transforming the future of energy is hard work, we provide competitive compensation, incentives, excellent benefits and the opportunity to build a rewarding career.

Are you in?

Primary Purpose
PRIMARY PURPOSE OF POSITION
Protect the Company's assets and self-insured retention by leading the investigation, management, and resolution of third party claims against the company, including the field investigation of bodily injury and property damage claims to include high profile cases with significant financial and reputational exposure, as well as the evaluation, case management and adjustment of claims. Investigate and pursue recovery for motor vehicle related subrogation claims. Direct and conduct the field and internal investigation of property damage, bodily injury, and fatality cases with an appropriate level of partnership and oversight. Assist in the oversight, auditing, training, coaching, and mentoring of Claims Case Managers. Assist in collection and review of claims data to prepare responses to data requests from both internal and external partners. Assist in enhancing data integrity through coaching and routine collaboration with Claims Case Managers. Assist in onboarding of new claims department employees and facilitating the retention of and transfer of institutional knowledge to aid in operational excellence. Obtain, retain and preserve physical evidence appropriately. Retain and partner with appropriate external experts to support evaluation, defense, and/or resolution of claims. Utilize claims adjuster, claims case handling, investigative, people skills and experience to mitigate financial risk, impact and/or loss to the company. Evaluate claim values and establish appropriate reserves on cases in accordance with established practices and procedures. Analyze liability and evaluate financial risk to the Company on bodily injury and property damage losses. Thoroughly document claim progress and investigation. Prepare summaries, written reports, and case analysis as required. Partner with the Legal and Litigation Departments to investigate, evaluate, litigate, negotiate, and resolve matters. Support Legal and Litigation in the litigation of claims cases, including but not limited to the discovery process. Support the loss prevention process. Provide on-call response to emergencies and significant events. Position is required to work extended hours for coverage for storms or other emergencies.

Primary Duties
PRIMARY DUTIES AND ACCOUNTABILITIES

  • Direct, perform, and coordinate field investigation of property damage, bodily injury, fatality, automobile accidents, fires, gas, environmental, company damage, and other incidents that involve potential liability issues for the company on a 24-hour basis. Respond to and coordinate the investigation of major incidents (gas explosions, fires, electrocutions) including significant company damage events on a 24-hour basis. Interview customers/claimants, witnesses, employees, contractors, etc. to obtain facts of incidents. Conduct thorough internal and external investigation, collecting, preserving, and evaluating documents and evidence. Prepare thorough and clear written investigation reports, letters, and other documents. (30%)
  • Efficiently and effectively adjust claims, evaluate damages, determine liability, analyze losses and where warranted develop a settlement strategy and negotiate a cost effective and appropriate settlement, and/or efficiently and respectfully communicate claims decisions and/or denials when appropriate. Thoroughly, timely, and accurately document and actively manage assigned claims to bring them to efficient and appropriate resolution. (30%)
  • Assist in the oversight, auditing, training, coaching, and mentoring of Claims Case Managers. Assist in onboarding of new claims department employees and facilitating the retention of and transfer of institutional knowledge to aid in operational excellence. Assist in enhancing data integrity through coaching and routine collaboration with Claims Case Managers to ensure consistency. (15%)
  • Conduct and support site investigations with appropriate expert support, as needed. Cooperate with the Legal department in support of litigation of cases brought against the company (10%)
  • Assist in collection and review of claims data to prepare responses to data requests from both internal and external partners, including e.g., rate case support (5%)
  • Provide educational and consultative services to internal and external constituents as appropriate. (5%)
  • Participate in other department business and accomplishment of work and goals as needed. Serve on Root Cause and/or Apparent Cause Investigations Team. All other duties as assigned. (5%)

Job Scope
JOB SCOPE

  • Protection of company assets (through proper and thorough investigations and claims handling practices)
  • Minimize Company Liability exposures (Thorough evaluation of claims, effective negotiation of settlements and appropriate claim denials)
  • Respectful, empathetic, efficient, and accurate Customer/client interactions
  • Effective financial management through adequate reserving, denials, and payments)
  • Self motivated requiring minimal supervision and an ability to handle a heavy case load and a rapid pace.
  • Perform comprehensive field and internal investigations.
  • Assisting in training, coaching, mentoring, and auditing Claims Case Managers.
  • Assist in data collection and review for comprehensive and accurate preparation of data request responses from internal and external partners, including rate case support, insurance support, Board and other executive requests.

Minimum Qualifications
MINIMUM QUALIFICATIONS
Bachelor's degree and 4-7 years of relevant investigative, claims or insurance experience, OR in lieu of a Bachelor's degree, 6-9 years of business experience, at least 6 of which must be relevant investigative, claims or insurance experience.

Preferred Qualifications
PREFERRED QUALIFICATIONS
10+ years of relevant investigative, claims or insurance experience, plus 3 to 5 years of utility experience, Active Claims Adjuster license (If applicable to position location)

Benefits

  • Annual salary will vary based on a candidate's skills, qualifications, experience, and other factors: $83,200.00/Yr. – $114,400.00/Yr.
  • Annual Bonus for eligible positions: 15%
  • 401(k) match and annual company contribution
  • Medical, dental and vision insurance
  • Life and disability insurance
  • Generous paid time off options, including vacation, sick time, floating and fixed holidays, maternity leave and bonding/primary caregiver leave or parental leave
  • Employee Assistance Program and resources for mental and emotional support
  • Wellbeing programs such as tuition reimbursement, adoption and surrogacy assistance and fitness reimbursement
  • Referral bonus program
  • And much more

Note: Exelon-sponsored compensation and benefit programs may vary or not apply based on length of service, job grade, job classification or represented status. Eligibility will be determined by the written plan or program documents.