PRIMARY PURPOSE
: To develop targeted solutions and provide added technical guidance and oversight to ensure matters are resolved optimally while creating a culture of continual quality improvement designed to elevate the overall claim handling to benefit our stakeholders.ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Proactively and strategically manages a complex claim inventory by assessing complex claims issues, utilizing jurisdictional expertise to provide oversight, and directs the handling to achieve the best possible resolution.
Acts as the organizational subject matter expert for line of business and key jurisdictions on complex claim issues.
Uses knowledge of all aspects of claims handling in evaluating exposure; recommends and directs action plans for issue or case resolution.
Articulates and documents clear and concise file notes to allow stakeholders to understand the issues and path to resolution.
Facilitates roundtables with groups/teams; engages appropriate internal and external resources as needed.
Provides technical leadership on and maintains co-ownership of complex claim issues; through further influence creates a culture of continual quality improvement.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
Travels as required.
QUALIFICATION
Education & Licensing
Bachelor's degree from an accredited college or university preferred.
Industry designation(s) preferred.
Casualty Adjuster Licenses required
Experience
Production Liability Claims Litigation experience required
Eight (8) years of casualty claims experience or equivalent combination of education and experience required to include three (3) to five (5) years of experience handling complex claims and experience in negotiation, mediation, arbitration or ADR skills on higher value complex claims.
Supervisory experience a plus.
Specific jurisdictional expertise preferred.
Skills & Knowledge
Subject matter expertise in worker’s compensation claims and/or liability claims processing
Ability to obtain and maintain appropriate licensing
Ability to manage claims across multiple jurisdictions
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Excellent analytical and interpretive skills
Strong organizational skills
Ability to work in a team environment
Ability to meet or exceed Service Expectations
Sedgwick
null
United States
Legal
(No Timezone Provided)
PRIMARY PURPOSE
: To develop targeted solutions and provide added technical guidance and oversight to ensure matters are resolved optimally while creating a culture of continual quality improvement designed to elevate the overall claim handling to benefit our stakeholders.ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Proactively and strategically manages a complex claim inventory by assessing complex claims issues, utilizing jurisdictional expertise to provide oversight, and directs the handling to achieve the best possible resolution.
Acts as the organizational subject matter expert for line of business and key jurisdictions on complex claim issues.
Uses knowledge of all aspects of claims handling in evaluating exposure; recommends and directs action plans for issue or case resolution.
Articulates and documents clear and concise file notes to allow stakeholders to understand the issues and path to resolution.
Facilitates roundtables with groups/teams; engages appropriate internal and external resources as needed.
Provides technical leadership on and maintains co-ownership of complex claim issues; through further influence creates a culture of continual quality improvement.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
Travels as required.
QUALIFICATION
Education & Licensing
Bachelor's degree from an accredited college or university preferred.
Industry designation(s) preferred.
Casualty Adjuster Licenses required
Experience
Production Liability Claims Litigation experience required
Eight (8) years of casualty claims experience or equivalent combination of education and experience required to include three (3) to five (5) years of experience handling complex claims and experience in negotiation, mediation, arbitration or ADR skills on higher value complex claims.
Supervisory experience a plus.
Specific jurisdictional expertise preferred.
Skills & Knowledge
Subject matter expertise in worker’s compensation claims and/or liability claims processing
Ability to obtain and maintain appropriate licensing
Ability to manage claims across multiple jurisdictions
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Excellent analytical and interpretive skills
Strong organizational skills
Ability to work in a team environment
Ability to meet or exceed Service Expectations