Client Claims Director
- Career Level
- Not Specified
The Client Claims Manager serves a designated client by collaborating in program enhancement design and driving client specific directives related to claim staff and processes. This individual uses analytic tools customized to their particular client centered view with a focus on adjuster activity around quality and outcomes. The individual is able to drive process and staffing change in collaboration with individual adjusters, team leaders and Service Center Managers.
The Client Claims Manager assists in supervision and overall management of the dedicated or designated claim staff servicing the Client. They assure the quality of our claim service to the client meets the Clients Special Handling Instructions as well as with our own Best Practices. The Client Claims Manager manages the statistical data controls to the Client. They serve as the claim liaison with the Client and the Service Centers and assure all staff are appropriately educated in service expectations and to acceptable standards. The Client Claims Manager will partner with adjusters and Team Managers to assist our claim operations in operating efficiently and effectively in all areas. This includes prompt and thorough claim investigations, timely and appropriate reserves which reflect anticipated exposure and organization of workflows to provide maximum productivity. The individual works to educate and train the staff on quality customer service, quality of SPOAs, Quality of Supervision, reserve controls, accurate data, claim file reviews/audits, litigation management and technical claim results. Confirm utilization of all agreed upon services and guidelines have been appropriately communicated including: Medical Management Services, Subrogation Vendors, SIU Services, Attorneys and/or other areas involved with the specific Program
- Assists in the section, training and development of an effective and efficient staff.
- Monitors key metrics on a daily, weekly or monthly level as needed. Key metrics include general metrics as well as those specifically targeting client initiatives.
- Along with Account Executive, communicates Clients expectations and ensures compliance via interaction with Team Manager and Service Manager.
- Provides claim specific guidance to staff as applicable ensure proper investigation and timely equitable disposition of claims. Makes recommendations on reserves exceeding pre-determined authority level; conducts periodic reserve reviews to identify areas of concern and work with Team Manager to resolve.
- Analyzes files on a periodic basis to determine accuracy and completeness and to maintain control of quality of work.
- Works with Team Manager and Service Center Manager to ensure that claim personnel are knowledgeable on client special handling instructions, carrier requirements and work reflects same.
- Keeps VP of Claim Operations informed verbally and in writing of activities and problems within assigned area of responsibility; refers matters beyond limits of authority and expertise to SVP and VP of Claim Operations.
- Participates in special projects or performs duties in other areas as requested.
- Undertake reviews, based on predetermined criteria or as applicable, to ensure proper investigation and data collection.
- Works with staff to ensure training has taken place in the proper evaluation of claims from a legal, medical, and financial standpoint.
- Handle client concerns quickly and efficiently to resolution
- Upholds the Crawford Code of Conduct
- College Degree preferred or education equivalent to a college degree or the equivalent experience in related work experience.
- Seven more years of progressive technical claim experience, including supervisory and/or management experience, demonstrating a high degree of judgment and discretion, is capable of providing adequate guidance and support on administrative and technical claim matters.
- Attainment of the Associate in Claims designation, and successful completion of, or active study for, I.I.A. MGT 43, and MGT 44, or the equivalent in related studies or work experience.
- Demonstrated ability to supervise the work of others.
- Demonstrates effective and diplomatic oral and written communication skills, and promotes a favorable company image to the public.
Broadspire (www.choosebroadspire.com), a leading international third party administrator, provides risk management solutions designed to help clients improve their financial results. Broadspire offers casualty claim and medical management services to assist large organizations in achieving their unique goals, increasing employee productivity and reducing the cost of risk through professional expertise, technology and data analytics. As a Crawford Company, Broadspire is based Atlanta, Ga., with 85 locations throughout the United States. Services are offered by Crawford & Company under the Broadspire brand in Europe (www.Broadspire.eu), including the United Kingdom (www.BroadspireTPA.co.uk).
In addition to a competitive salary, Crawford offers you:
- Career advancement potential locally, nationally and internationally. Crawford & Company has more than 700 locations in 70 countries;
- On-going training opportunities through every stage of your career
- Strong benefits package including matching 401k; health, dental, and life insurance; employee stock purchase plans; tuition reimbursement and so much more.
Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V
Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.