Complex Claims Manager

Maleda Tech

3d • Onsite

About The Position

The Claims and Risk team is responsible for ideating, building, launching, and managing the host and guest protection program. We have a significant responsibility to our community of hosts and guests to be there when things do not go as planned with their reservations. We are looking for a Complex Claims Manager who will help us deliver best-in-class claims service while protecting the integrity of the protection platform. As a Complex Claims Manager, you will play a vital role in safeguarding the integrity of the protection platform by identifying, investigating, and managing risk and mitigation strategies in the resolution of complex and large loss claims. You will manage internal and external partners to influence prioritization, drive accountability, deliver improvements, and scale changes on claims that impact the business. You will work closely with cross-functional teams to manage emerging risks and threats while enabling business growth in various markets. The philosophy is to identify intelligence and risk gaps and partner with internal risk management teams (such as Trust and Safety), third-party adjusters, brokers, Platform Product Management, Global Crisis Management, Community Support, Policy, and Privacy and Legal teams to strengthen the platform. You will report at monthly, quarterly, and annual business reviews for your area, and serve as a thought leader with stakeholders such as Trust, Legal, Privacy, Safety, Product Management, and Policy, helping the team understand how the policy and product roadmap impacts risk mitigation of emerging threats.

Requirements

• Detail-oriented and able to understand the bigger picture, using technical expertise and problem-solving abilities to identify and manage blocking issues
• Able to work in a global, fluid environment with intense focus to execute at high quality through to completion
• Apply critical thinking to new and complex claims, and adapt learned knowledge to anticipate the needs of future claims
• Analytical: Excellent analytical and problem-solving skills, with the ability to navigate Complex and Large Loss claims and identify risk and exposure to the business
• Complex claims resolution: Strong knowledge of techniques, investigative methodologies, and legal aspects of complex and severe claims resolution
• Strong communication: Strong verbal and written communication skills, with the ability to explain complex topics to diverse audiences. Skilled at presenting complex and sensitive customer issues, and at analyzing large data sets to draw reasonable conclusions
• Cross-functional influence: Proven ability to collaborate effectively across disciplines, regions, and seniority levels. Strong negotiating skills and experience communicating recommendations to internal and external stakeholders
• Judgment: Sound, balanced decision-making in ambiguous and high-stakes situations, with the ability to determine liability swiftly and judiciously based on available information
• Proactively work towards a fair and suitable resolution for claims in a timely manner, employing effective conflict resolution strategies
• Evaluate and interpret policy language and relevant case law alongside specific loss details to make informed coverage decisions
• Coordinate loss investigations with external experts across various exposures and manage the adjustment process through to final resolution
• Advocate for high quality standards, innovation, conflict resolution, and customer experience excellence
• High attention to detail when working on complex cases
• Experience working with internal stakeholders and third-party providers to resolve complex disputes in a detailed, effective, and timely manner
• 10+ years of Insurance Claims Coverage and Litigation experience, with an emphasis on liability and property
• Strong Insurance Policy experience
• Demonstrated ability to identify and resolve issues through effective problem-solving skills
• Proven ability to negotiate skillfully in difficult situations with both internal and external groups

Nice To Haves

• Deep technical claim, legal, and risk knowledge
• Knowledge and understanding of Casualty and Property Insurance Policies and Claims
• Knowledge and understanding of legal and claims complexities in North America, LATAM, and EMEA
• Strong regulatory experience
• Ability to work cross-functionally with leaders across Community Support, Platform Product, Finance, Legal, and Data Science
• Understanding of Captive Insurance
• Understanding of FINC claims
• BA / BS degree in a business or technical field preferred.

Responsibilities

• Build partnerships and lead Large Loss Claim reviews with insurers on a monthly or quarterly basis (depending on the insurer or market). Manage insurer claim handling, potential coverage and relationship issues, and material reserve changes that could impact the business and the Captive
• Craft a Resolution Plan for Complex and Large Loss Claims, driving the Carrier and/or TPA to resolve the claim while meeting the needs of internal stakeholders
• Partner with Legal, Global Crisis Management, Trust, Brokers, Insurers, Outside Counsel, and TPAs on complex claims resolution, including coverage issues and settlement authority
• Own performance and results with Insurance Carriers and Partners worldwide for Complex Claims that may impact policy limits or trigger notice to Brokers and Carriers under the insuring policies
• Mentor junior Host Damage Protection and Host Liability Protection Specialists, supporting their growth and development and guiding them through complex claims and changes
• Manage claims that impact company financials and the Captive
• Collaborate with internal departments (other Claims Operations teams, Legal, Trust, Customer Support, Safety) to share claim insights, improve claim handling by carriers and TPAs, and develop Resolution Plans that bring claims to the right conclusion
• Ensure compliance with company policies, procedures, and legal requirements related to claims handling
• Mentor others by simplifying complex information across claims knowledge, data analysis, business information, and process obstacles

What This Job Offers

• Job Type: Full-time
• Career Level: Senior