Complex Claims Director – TPA Oversight
AIG
full-time
Posted on:
Location Type: Office
Location: Lenexa • Illinois, Kansas, North Carolina • 🇺🇸 United States
Visit company websiteJob Level
Lead
About the role
- Analyze and process bodily injury and third-party property damage claims by investigating and gathering information to determine the exposure on the claim.
- Ensure proactive claims handling aimed at the prompt and cost-effective resolution of claims through well-developed action plans.
- Determine need for and direct independent adjusters to gather information to determine exposure on the claim and control their costs.
- Identify and evaluate coverage issues; prepare comprehensive coverage letters with supervisory review and analysis; retain and provide direction to coverage counsel when necessary.
- Assess liability and resolve claim within established evaluation.
- Maintain diaries and complete tasks within required timeframes as set forth by department guidelines; ensure claim files are timely and properly documented with clear and concise analysis on coverage, damages, reserves, and liability including an action plan for resolution.
- Process and pay invoices within a timely manner.
- Coordinate vendor referrals for additional investigation and/or litigation management.
- Calculate and assign timely and appropriate reserves; monitor reserve accuracy throughout the life of the claim.
- Refer case as appropriate to supervisor and management.
- Respond to requests or directions in a professional and timely manner.
- Attend arbitrations, mediations, settlement conference and trials.
- Successfully complete required State licensing examinations and continuing education requirement.
- Communicate with all internal business partners including underwriters to make sure underwriting is aware of large losses and industry trends.
- Partner with TPA Governance and Relationship Management to help TPA’s and Insureds comply with claim handling and reporting guidelines.
- Work with TPA Claims Financial to check the accuracy of TPA financials ensuring alignment with TTPO financials.
Requirements
- 7 plus years of General Liability/Auto claims experience.
- Experience with complex and high exposure General Liability Bodily Injury and Property Damage claims.
- Excellent communication skills (verbal/written) and strong negotiation skills.
- Advanced experience and capabilities in litigation claims management, including ADR and mediation processes, involving auto/GL exposures.
- Strong technical expertise interpreting insurance contracts.
- In depth knowledge of claim handling procedures, claims performance strategies, and claim best practices.
- Advanced analytical and problem solving skills.
- Demonstrated ability to initiate and champion change initiatives that leverage technology and improve skills in benchmarking.
- Creativity in resolving challenging business problems, as well as ability to achieve business goals and objectives is essential.
Benefits
- Our Total Rewards Program, a comprehensive benefits package that extends beyond time spent at work to offer benefits focused on your health, wellbeing and financial security—as well as professional development.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
claims analysisclaims handlingcoverage evaluationliability assessmentreserve calculationlitigation managementADR processesinsurance contract interpretationclaims performance strategiesproblem solving
Soft skills
communication skillsnegotiation skillsanalytical skillscreativitychange managementcollaborationtime managementprofessionalismleadershipinitiative
Certifications
State licensingcontinuing education