Job Description

Under limited direction, lead the investigation and timely disposition of first and third party claims. These claims may require a high level of technical experience and may involve large damages and/or questions of coverage. Oversee team performance and production to ensure Claim department goals are achieved in support of the business plan. Responsible for execution of tactical, day-to-day activities and imparting functional technical expertise.

Key Responsibilities

• Select, train and develop an effective and efficient staff

• Establish and communicate clear performance standards and objectives

• Conduct performance evaluations; recommend salary adjustments, promotions, transfers, and dismissals

• Counsel employees on educational and job opportunities which will enhance their career development

• Spend time coaching, mentoring, training, and developing their staff, addressing other responsibilities that need to be done at this level, and an appropriate work-life balance has been achieved

• Ensure exceptional customer service and high quality work is delivered from direct reports

• Monitor operations and staff and recommend, when necessary, changes in methods, procedures, structure and additions or changes in personnel to secure optimum utilization of resources

• Keep staff informed of current problems, changes and new developments in the department and company by conducting periodic meeting

• Administer all policies and procedures contained in the Arbella Employee Handbook; communicate to staff, interpret as necessary, and ensure compliance

• Monitor reports on productivity trends; recommend and implement changes on an ongoing basis to improve productivity

• Compile and analyze data and create reports to provide information to management

• Operate, input and retrieve information using the automated claim system; request checks, form letters and other correspondence through the automated claim system

• Analyze claim files, write directives concerning the files and assign or reassign files to claim representatives

• Review files on a periodic basis to determine accuracy and completeness and, if required, issue directives for further investigation, evaluation, negotiations and/or contact with legal channels

• Monitor the accuracy, completeness, and the appropriateness of billings (e.g. legal, medical, appraisal) when reviewing claim files

• Review reserve recommendations, establish reserves and make recommendations on reserves exceeding authority

• Provide the necessary guidance to unit personnel on investigations, appraisals of damages, liability, coverage and settlement techniques

• Assist in establishing Claim Office objectives supportive of the Claim Department business objectives

• Assist in the selection and evaluation of defense attorneys, medical examiners and independent adjusters

• Review and assist in preparing suit cases for forwarding to legal counsel, checking to assure that coverage is not exceeded, that legal reserves are adequate and confer with attorneys about these matters

• Service new larger risks and agents within Claim Office territory

• Organize workflows of the automated claim system to provide maximum productivity

• Assist in the training of new Claims Technical Team Managers

• Control expenses to meet the Claim Office budget and keep expenditures to a minimum

• Extend settlement authority as warranted and/or investigate and settle difficult cases as required or requested to assure proper investigation and disposition of all cases

• Attend trials, no-fault medical arbitration, and inter-company arbitration hearings, if requested

• Assist in the training of staff in the operation and uses of the automated claim system

• Monitor workplace and work practices to ensure safe office conditions, and make recommendations and/or changes as necessary

• Keep Manager informed verbally and in writing of activities and problems within assigned area of responsibility; refer matters beyond limits of authority and expertise to Manager for direction

• Perform other related work as required or requested

Requirements