Workers Compensation Claims Team Leader - Claims Department
MMC

Job Info

Provides high level expertise and reviews (complex) escalated claims in order to determine coverage and what policies will be impacted by a claim and provides resolution where possible, otherwise refers claim to Claims Advocate to ensure the proper processing of claims.

Reviews and ensures team understands incoming documentation and new claims notifications for high profile clients and serves as point of contact regarding any potential problems or contentious claims in order to ensure the proper protocol is followed.

Maintains regular contact and serves as an advisor to a portfolio of complex and/or large clients to build trust, deliver service and maintain effective working relationships.

Liaises with clients for claim-related issues or client service concerns to resolve issues of highly complex or high value claims/clients with insurers on claims notifications, updates, information requests, queries, keeping all relevant parties informed of high level concerns such as contentious claims or general claims trends, as appropriate.

Participates in and organizes internal and external audits as appropriate and provides feedback and recommendations for improvements to help the department improve its operations, particularly in geographies with a variety of large and complex clients.

Mentors, provides guidance and develops formal and informal training for colleagues to improve the knowledge base of the department.

Provides guidance in resolving issues with non-paying insurers for outstanding settlements to retain key relationships and protect the interests of large/complex clients.