Claim Account Manager

Role Overview

• Ensure compliance with all local, federal and state regulations related to claims while minimizing risk/exposure to the Arch organization
• Provide technical expertise and oversight to TPA adjusters handling workers compensation, auto liability & general Liability claims which also include handling and supervision of outsourced claims
• Work with our TPA’s to ensure proper claims handling and service delivery
• Perform claims oversight on claims with an expected value of over $50,000 for guaranteed cost policies and at 50% of the retention for deductible and self-insured business
• Attend mediations and trials
• Granting reserve and settlement authority on cases above the TPA’s authority
• Making coverage determinations and writing Reservation of Rights and coverage disclaimer letters
• Completing claims audits at TPA branch claims offices or online
• Handling or facilitating administrative tasks between Arch and the TPA to ensure seamless service delivery to the client
• Act as the Service Manager/Arch claims contact for all accounts written by NAC
• Participate in client set-up meetings
• Participate in telephonic as well as in person claims reviews
• Participate in mid-term meetings
• Help to resolve any claims or service issues that arise
• Work with Underwriting and Risk Control to assist in the risk selection process
• Review new/renewal submissions and commenting on any claims, legal or jurisdictional issues
• Address potential solutions to current claims or service problems
• Participate in meetings with brokers and/or prospective accounts
• Identify loss trends on an account or book of business level
• Conduct due diligence reviews on new TPA’s or accounts that want to self-administer claims
• Collaborate with other internal business units such as Finance, IT and Legal on any issues or projects that arise
• Address state and federal regulatory issues (Medicare issues, state insurance department audits/complaints, state workers compensation board requirements, etc.)

Requirements

• Bachelor's degree preferred
• Exceptional communication (written and verbal), influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines
• Strong problem-solving, analytical, organizational, multitasking, and time management skills
• Ability to take part in active strategic discussions
• Ability to analyze and utilize data to make direct impact on claims outcomes
• Minimum of ten (12) years’ working experience overseeing and managing multi-line claims including auto liability, general liability, workers’ compensation, products and professional liability for high deductible and self-insured accounts
• Experience monitoring committee process
• Proper Adjuster Licenses in all applicable states
• Ability to handle high severity claims
• Knowledge & expertise with multiple jurisdictions
• Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word
• Ability to work independently and in a team environment
• Willing and able to travel 25%

Benefits

• multiple medical plans plus dental, vision and prescription drug coverage
• competitive 401k with generous matching
• PTO beginning at 20 days per year
• up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Off
• basic Life and AD&D Insurance as well as Short and Long-Term Disability
• Paid Parental Leave of up to 10 weeks
• Student Loan Assistance and Tuition Reimbursement
• Backup Child and Elder Care
• more