Assistant Claims Manager - Workers Compensation- Hybrid Opportunity -
PMA Companies

Job Info

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Job Description:

Provides strategic and technical claims leadership for claims staff in collaboration with the Regional Claim Officer, to ensure appropriate claim outcomes through consistent execution of best claims practices. Directs staff in the achievement of business plan goals and compliance with legal statutes, policy provisions and company guidelines. Manages the execution of quality assurance actions.

Responsibilities:

• Develop, recommend and implements short and long term objectives consistent with company business goals, guidelines and program
• Ensure consistent value-added claims service is delivered to our clients. Manage the resolution of service issues to ensure superior customer service.
• Effectively plan staff responsibilities and manage activities, utilizing staff resources to meet department goals in accordance with established business plans and budgets
• Monitor and analyze significant legal developments and legislative changes in service territories that may impact claim operations; communicates conclusions and recommendations to the appropriate parties
• Promote effective communication among and between work groups, and between management and employees. Collaborate with Corporate Specialists, Underwriting and Risk Control to ensure comprehensive service to our clients
• Provide strategic and technical claims leadership for assigned supervisors and staff in collaboration with the Regional Claim Officer and Corporate Team
• Direct assigned supervisors and staff in the achievement of business plan goals and compliance with legal statutes, policy provisions, special handling and company guidelines while fostering a culture of customer service excellence and professional accountability
• Ensure quality management of claims in accordance with best practices and company guidelines
• Provide coaching and training of assigned supervisors, as well as directly supervised staff, to develop technical proficiency, customer service excellence and leadership
• Ensure delivery of timely, high quality customer service from assigned supervisors as well as direct report staff
• Coordinate the effective delivery of managed care services ensuring consistent execution of managed care standards and guidelines
• Coordinate with the Regional Claim Officer the recruitment and hiring, performance management and resolution of employee relations issues within the branch; promoting effective communication among and between work groups
• Grant reserve and settlement authority on cases exceeding supervisor authority and ensure consistent execution of the CIR program for assigned supervisors
• Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.

Requirements:

• Bachelor's Degree or equivalent experience
• Typically 10 or more years of claims experience in positions of increasing responsibility
• Extensive knowledge of claims regulations and applicable laws with specific knowledge of Workers' Compensation within servicing states
• Extensive knowledge of insurance contracts, adjusting techniques and medical terminology
• Previous experience in a leadership position with proven record of goal achievement and superior customer service
• Excellent verbal and written communication skills
• Professional designations desired (CPCU, ARM, AIC)

This job has expired.