Claims Team Lead

Company Details

BerkleyNet is an innovative workers compensation insurance provider that does all of our business online. Our Goal? To make doing business “Ridiculously Fast. Amazingly Easy.”

Responsibilities

As a Claims Team Lead, you will be responsible for the administrative and technical supervision of a team of workers’ compensation claims professionals. We’ll look to you for staff training, development, and performance management; to monitor claim handling activities; and provide technical and jurisdictional specific direction and feedback to ensure timely and accurate investigation and adjudication of claims to produce quality outcomes.

 

• Supervises all technical aspects of claims including coverage investigation, disability benefits management, medical management, file management, litigation management, subrogation, reserving and settlement.
• Provides team with technical training and claims handling guidance and direction
• Reviews reserve and settlement amounts over the Claims Representative authority level for approval
• Ensures claims are clearly and adequately documented, and ensures claims data is captured and coded correctly within the claims management software system
• Provides team support, leadership and motivation to promote a high level of performance
• Establishes team performance goals and objectives in alignment with business plans
• Directs team toward the achievement of established goals and objectives
• Performs claims quality reviews in compliance with audit requirements and quality standards on a monthly and quarterly basis
• Identifies and alerts senior management to claims trends or issues
• Resolves escalated policyholder and claimant issues related to specific claims
• Conducts regular coaching and performance feedback discussions
• Establishes performance and career development plans in collaboration with team members, management & HR
• Assures claims representatives are properly licensed or certified in assigned jurisdictions
• Partners with HR and management on engagement strategies to improve employee engagement, job satisfaction, and create a psychologically safe work environment
• Administers all company personnel policies and addresses and resolves personnel matters with the support of management and HR
• Conducts interviews of prospective claims representative candidates and provides feedback to assist senior management with hiring decisions
• Maintains and demonstrates knowledge of the Workers’ Compensation Act, adjudication process, and regulatory compliance framework in assigned jurisdictions
• Attends and participates in claim file reviews with senior management and defense attorneys
• Coordinates and leads special projects or processes as assigned by senior management
• Continuously strives to improve our product and business results through innovation
• Obtain and maintain adjuster license in multiple jurisdictions

Qualifications

• Minimum 3 years of experience (4 – 5 years preferred) handling workers’ compensation claims in multiple jurisdictions
• Supervisory experience preferred but not required
• Exceptional leadership and motivational skills
• Excellent written, verbal, interpersonal and relationship building skills
• Excellent time management and organization skills
• Strong analytical and critical thinking skills
• Ability to effectively manage and develop talent
• Ability to implement policies, procedures and controls to measure and improve service and financial performance
• Ability to work independently and strategically problem solve
• Ability to diplomatically manage conflict
• Ability to develop relationships within the organization and work effectively across departments
• Strong discretion and integrity in dealing with highly confidential and sensitive information
• Detail oriented
• Ability to quickly learn to intuitively use internal systems

Education Requirement

• Bachelors’ degree or equivalent insurance industry work experience
• AIC, ARM, CCP, or CPCU insurance designation preferred

Additional Company Details

*The above job description is not intended to be an “all-inclusive” list of the duties and responsibilities of the job described, nor is it intended to be such a listing of the skills and abilities required to do the job.  Rather, it is intended only to describe the general nature of the job. The Company is an equal employment opportunity employer. We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees • Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. - Base Salary Range: 85k-110k The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.

Additional Requirements

Travel Requirements Low level of domestic U.S. travel required (up to 10% of time) Ability to travel nationally to attend legal hearings, conferences, trainings, file reviews and audits