Head - Insurance - Claims Coordinator

Job description:

- Responsible for coordinating and supporting initiatives relative to the evaluation, processing, and handling of claims for an organization.

- Acts as a liaison between the organization, its insurance provider and agents, claimants, and policyholders regarding the status and eligibility for coverage for all relevant claims.

- Reviews claims to make sure that billing requirements are met, updates accounts as necessary, answers inquiries, and makes recommendations for resolution

- Review settled insurance claims to determine that payments and settlements have been made in accordance with company practices and procedures.

- Report overpayments, underpayments, and other irregularities. Confer with legal counsel on claims requiring litigation.

- Manages regional claim operation through subordinate managers who have accountability for the book of claims as well as employee selection, development and performance management.

- Monitors claims metrics to ensure the departments are meeting financial and non-financial objectives. Decisive action taken when results are not meeting objectives.

- Responsible for monitoring of reserves and leakage. Participate in Corporate Claims Reserve Reviews.

- Monitor and ensure compliance with unfair claim practice acts, adjuster licensing and continuing educational requirements.

- Prepares and monitors regional annual operating budget.

- Responsible for controlling operating expenses within budgetary guidelines and makes recommendations for cost effective reductions.

- Continually monitors current practices and procedures ensuring protocols are met to achieve business unit objectives.

- Evaluates and recommends improvements /enhancements to Senior Management.

- Review and analyze the Claims staffing analysis reports in order to achieve the most effective and efficient use of managerial, technical and clerical Claims.

- Recommend hiring, promotion and termination of Claims managerial, technical, and clerical staffs and comply with the corporate salary guidelines.

- Review and endorse Performance Evaluations for Field Claims management personnel and prepare Performance Evaluations for personnel reporting direct.

- Conduct periodic Quality Control spot checks on the technical and clerical staffs of each Claims Office. Participate in the Quality Control Review wrap-up sessions which will be conducted after each Home Office review.

- Review and recommend settlement and expense authority for Claims personnel.

- Maintain an open line of communication with the national line of business Vice Presidents and the technical segment of the Shared Services Claims Department.

- Visit agents to continue and encourage our excellent Claim Department/Agency relations and continue to provide quality service to the agents and their clientele.

- Communicate with the Casualty and Property specialized technical units on large losses, policies and procedures, and settling difficult claims.