Senior Claims Account Manager-Work Comp and Liability

Senior Claims Account Manager-Work Comp and Liability

Requirements

• Must have good business acumen (i.e. understand how an insurance company works and makes money, including how this role impacts both Argo Group and our customers’ ability to be profitable).
• A deep knowledge of managing TPA performance typically obtained through a Bachelor’s Degree from an accredited university is required. Two or more insurance designations or four additional years of related experience adjudicating workers’ compensation claims beyond the minimum experience required above may be substituted in lieu of a degree.
• At least seven years of liability and workers’ compensation claims and experience handling specialty programs with experience managing TPAs, MGAs, or other outside vendors required.
• Advanced technical expertise related to liability and workers’ compensation policies, claims resolution, and skills and knowledge of insurance and claims settlement principles, practices and procedures.
• Experience conducting audits with a proven ability to communicate and present findings accordingly.
• Strong communication, negotiation and presentation skills. Ability to effectively interact with all levels of the company’s internal and external business partners.
• Advanced analytical and problem-solving skills, with the ability to manage and prioritize multiple projects.
• Ability to partner with finance, actuarial, IT and marketing resources.
• A strong focus on execution in getting things done right. Proven ability to consistently produce and deliver expected results to all stakeholders by finding a way to achieve success through adversity, being solution (not problem) focused, and thinking with a global mindset first.
• Client focus – the ability to effectively determine specific client needs and to provide value added solutions.
• Strong focus on selection – determined to have the right people who do the best job. Has a reputation for his/her ability to identify, attract, and hire talented people.
• A team builder, someone who understands that success is dependent upon the performance of the team and not individual team members. Creates strong morale and spirit within the team: shares wins and celebrates success as a team.
• Dedicated to developing talent. Understands and is committed to teaching technical skills and developing people so that they realize their full potential.
• Ability to establish mentoring relationships with key employees and participates in the development of succession and training plans for all positions. Empowers others by driving decision-making, authority, and resources to trusted employees and providing stretch assignments.
• A relentless desire to continually update your skills through continuing education and self-development.
• Demonstrates inner strength. Has the courage to do the right thing and demonstrates it on a daily basis.
• Intellectual curiosity. Consistently considers all options and is not governed by conventional thinking.
• Ability to build commitment both internally and externally. Ability to communicate corporate vision and to gain support for your views, opinions and decisions.
• Ability to develop and maintain productive relationships with clients, business partners and organizational peers with a focus on timely and meaningful exchanges of information.
• Ability to regularly exercise discretion and independent judgment with respect to matters of significance.
• Polished and professional written and verbal communication skills.
• Ability to articulate the financial value of your work at multiple responsibility levels inside our business including Argo senior executives.

Responsibilities

• Monitor the quality of work performed by internal employees or TPAs adjusting claims for US programs. Act as the single point of contact for all assigned programs for both internal and external customers. Provide industry leading customer service and communicates effectively with the goal of building and maintaining internal and external customer relationships.
• Participate in audit and claim review process for all assigned program.
• Effectively monitors work of assigned TPA’s to ensure quality claim handling and compliance with Claims Administration Agreements and Claim Reporting Requirements. This includes engaging in effective oversight of complex and escalated claims, ensuring quality assurance audits are completed timely with appropriate reporting and follow-up, and using Power BI reports, dashboards and audit results to understand and address TPA performance and trends.
• Engage in new Program and TPA implementations and manage all aspects of implementation.
• Robust communication with Actuary, Programs Underwriting and VP of Program Claims of TPA and Program performance and trends.
• Manage the Program Claims Compliance Specialist position. This position provides administrative support to the Programs Department and supports EDI processing, reporting, and resolutions.

Preferred Qualifications

No preferred qualifications provided.