Claims Team Lead - Liability
About The Position
The Claims Team Lead supervises multiple teams of liability claims examiners and technical staff. The role monitors workloads and claim activities, provides training and technical and jurisdictional direction on claims adjudication, and maintains claim diaries, particularly for complex or high-exposure claims. The Team Lead reviews management reports and claim quality, escalates trends and issues, handles appeals, reviews reserves on high-cost claims, and maintains client relationships. The role also oversees licensing, file coding, and documentation, and administers personnel policies and colleague performance and development processes.
Requirements
- Six years of claims experience, or an equivalent combination of education and experience.
- Two years of claims supervisor experience.
- Licenses as required for the role and jurisdictions served.
- Ability to think clearly and conceptually and demonstrate sound judgment, troubleshooting, problem-solving, analysis, and discretion.
- Ability to manage work-related stress, multiple priorities, and deadlines.
- Ability to perform computer keyboarding and travel as required.
- Ability to hear, see, and speak.
Nice To Haves
- Bachelor’s degree from an accredited college or university preferred.
- Professional certifications applicable to the line of business preferred.
Responsibilities
- Supervise multiple teams of examiners, product-line examiners, and/or at least seven technical operations colleagues; delegate duties when appropriate.
- Identify and advise management of trends, problems, and issues, recommend actions, communicate process-improvement ideas, and coordinate office projects.
- Provide technical and jurisdictional direction on examiner claims-adjudication reports.
- Compile, review, and analyze management reports and take appropriate action.
- Conduct claims quality reviews in accordance with audit, service-contract, and quality requirements.
- Serve as the second level of appeal for client and claimant concerns involving claim-specific, procedural, or special requests, and implement final appeal dispositions.
- Review reserves on high-cost claims and claims exceeding an individual examiner’s authority.
- Monitor third-party claims and periodically review litigated, serious vocational rehabilitation, questionable, and client-designated sensitive claims.
- Maintain client contact, promote professional client relationships, recommend actions based on claim status, and provide written claim summaries when requested.
- Ensure direct reports hold required licenses in the jurisdictions served.
- Ensure claims files are correctly coded and adequately documented by examiners.
- Support the organization’s quality programs and perform other assigned duties.
- Administer personnel policies and follow staffing standards and training recommendations.
- Interview and hire colleagues, establish performance development plans, and conduct performance discussions.
- Provide support, guidance, leadership, and motivation to promote colleague performance.
Benefits
- Flexible work schedule.
- Referral incentive program.
- Opportunity to work in an agile environment.
- Career development and promotional growth opportunities.
- Medical, dental, and vision coverage.
- 401(k) and matching, available on day one.
- Paid time off (PTO).
- Disability and life insurance.
- Employee assistance program.
- Flexible spending account or health savings account.
- Additional voluntary benefits.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
