P&C Claims Team Lead

RH Wine & Co LLC • St. Charles, IL

17d • $85,000 - $105,000 • Hybrid

About The Position

Are you a driven, ambitious, and energetic sales professional looking for your next challenge? Join Insurance Program Managers Group (IPMG) and become part of a dynamic team committed to innovation! For the past 27 years, our mission has been to create one-of-a-kind solutions for our partners. We bring proactive and tailored approaches to our clients, valuing the unique contribution of each team member. Together, we shape our identity and drive transformative change for our clients.

We are seeking aPC Team Leader. This role is a full-time, exempt position. It is an entry-level management position for a driven professional seeking to grow his/her career in the property and casualty arena. This role supports the Claims Manager in Unit objectives with oversight of direct reports and minimal inventory. This is a work from home hybrid position with 2-3 required weekly days in office based on performance production.

Responsibilities

• Ensures Claims Best Practices guidelines are followed consistently 
• Ensures that defined processes, quality standards and procedures are followed 
• When appropriate, coaches to ensure contact with employers, injured employees, doctors, witnesses, and other parties are secured and obtain details about the loss 
• Coaches and reviews claim related correspondences and determines appropriate actions are made 
• Maintains files notes in accordance with established procedures, maintains timely diary management, updates accurate coding and claim closing goals and coaches to same
• Ensures timely review of intervention alerts to ensure adjuster compliance in all facets of their claims handling with proper oversight and direction noted on such claims as outlined in the Best Practice Guidelines
• Coaches to ensure adjuster provides timely and proactive information to clients, claimants, insureds, and others regarding the status of claims 
• Ensure Team sets initial and on-going reserves for incurred costs and authorizes or denies payments while using control reports to monitor
• Works with defense counsel and adjusters regarding questionable complex settlements to ensure most probable outcome 
• Ensures subrogation opportunities are consistently identified and executed by team members
• Effectuates accurate and timely claim transfer to correct level adjuster as prescribed by client service plan and/or Best Practice Guidelines.
• Effectively teaches negotiation skills for settlements where appropriate
• Ensures team is compliant with litigation management handling guidelines, including timely evaluations from defense counsel with budget discipline accountability
• Ensure team understands and properly maintains Medicare screens to meet Section 111 requirements, including other required claim screen coding 
• Coaches team to execute on 90-day interface claim reviews with quality and timeliness as prescribed by BPG
• Well versed in multiple jurisdictions (where applicable)
• Communicate effectively with all internal and external business partners.
• Written and verbal communication is professional and timely and coaches their team to the same
• Communicate effectively by expressing oneself in a clear and concise manner in one-one and group discussions while listening attentively in collaborative discussions
• Foster a sense of energy, urgency, ownership, and personal commitment to work
• Participation and coordination in client claim reviews and/or teleconferences 
• Present and assemble claim file review memorandums as needed
• Occasional travel to clients for claim reviews where warranted
• Timely follow-through on all agreed action items with internal and external stakeholders that have been committed to 
• Achieves all metric goals for adjuster and leader outlined by department manager within scorecard
• Identify and assist with ongoing training needs in all areas of PC Department for new and existing staff
• Coordination claim discussions with appropriate stakeholders such as adjusters, underwriters, legal and PC Leadership to drive calibration and alignment in file outcome
• Collaborate internally before communicating decisions with business partners and clients
• Manages PTO requests of their direct reports keeping in mind overall capacity of Unit and back up plans where necessary  
• Reviews and analyzes managerial control reports to determine outliers and takes the necessary action with staff as warranted
• Addresses Excess Reinsurance Collect Reports with quality and urgency to ensure timely client reimbursement by team
• Demonstrate an understanding of the organization’s goals and how they contribute to the company’s overall success and shares with team to aid in providing understanding of company objectives
• Establishes action plans and strategies to help individual and team achieve goals.
• Uses influence skills to provide sound rationale for recommendations using data to support recommendation when relevant.
• Provide honest, helpful and actional feedback while seeking validation of execution
• Cultivates an inclusive environment that allows all to feel valued and strive for strong performance
• Assesses performance of capabilities and job fit to track performance against objectives
• Gathers and analyzes data to aid in problem solving to understand root cause and best solution 
• Convey clear expectations and follow up for ensured execution
• Holds staff accountable including performance management if necessary for achieving goals
• Identifies and communicates action steps needed to accomplish objectives
• Completes quality reviews and feedback through direct supervisory reviews/audits in compliance with organizational Best Practices Guidelines top of mind
• Shares strengths and opportunities with Sr. Leadership
• Supports and assists in strategy development and implementation of initiatives
• Promotes culture of collaboration and teamwork across all organizational boundaries
• Assist in identification, recruiting, interviewing and hiring as determined by their manager 
• Complete evaluation write-up and verbal feedback of employees for performance reviews excluding salary/merit portion of discussion. 
• Supervises claim files as outlined in the Best Practice Guidelines  
• As this position has been deemed a “working-Team Leader’s” position, this person will also have a partial caseload for assigned clients. The desired caseload is ~25-50 depending on complexities.  All responsibilities that apply to Sr. PC Adjuster will also apply to this job function. (See Sr. PC Job Description)

Benefits

• 20 days of PTO each year.
• 12 paid holidays and YOUR BIRTHDAY OFF!
• Medical, dental, and vision coverage on day one of full-time employment.
• Telemedicine is free for you and your family (day one) if you are covered under our medical plan.
• 401k match.
• Professional development support.
• Flexible time off with an encouraged minimum time away to support a healthy work-life balance.
• Life Insurance, Short term, and long-term disability on day one of full-time employment.
• Onsite fitness center and showers, in our St. Charles, IL HQ office.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed