Sr. Claims Account Manager, Construction

Claims Account Manager (CAM/AVP)

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠.

The Claims Division is seeking a Claims Account Manager (CAM/AVP) to join the Central Construction Team. In this role, the incumbent will actively manage and effectively oversee Third-party Administrator (TPA) Team members handling Construction Worker's Compensation and construction liability claims (GL, AL, APD) for high-exposure commercial business accounts.

Responsibilities

Work with our TPA's to ensure proper claims handling and service delivery, this includes:

• Performing claims oversight on claims with an expected value over $50,000 for guaranteed cost policies and at 50% of the retention for deductible and self-insured business
• Attending mediations and trials
• Granting reserve and settlement authority on cases above the TPA's authority
• Making coverage determinations and writing Reservation of Rights and coverage disclaimer letters
• Completing claims audits at TPA branch claims offices or online
• Handling or facilitating administrative tasks between Arch and the TPA to ensure seamless service delivery to the client

Act as the Service Manager/Arch claims contact for all accounts written by Arch Underwriting, which includes:

• Participating in client set-up meetings
• Participating in telephonic as well as in person claims reviews
• Participating in mid-term meetings
• Helping to resolve any claims or service issues that arise

Work with Underwriting and Risk Control to assist in the risk selection process, which includes:

• Reviewing new/renewal submissions and commenting on any claims, legal or jurisdictional issues
• Addressing potential solutions to current claims or service problems
• Participating in meetings with brokers and/or prospective accounts
• Identifying loss trends on an account or book of business level
• Conducting due diligence reviews on new TPA's or accounts that want to self-administer claims

Collaborate with other internal business units such as Finance, IT and Legal on any issues or projects that arise

Address state and federal regulatory issues (Medicare issues, state insurance department audits/complaints, state workers compensation board requirements, etc.)

Experience & Required Skills

Minimum of ten (10) years' working experience overseeing TPA's and managing WC, AL, GL, APD claims (bodily/personal injury and property damage) for high deductible and self-insured accounts; preferred 15+ years

TPA Oversight or leadership experience required

Ability to handle high severity claims

Knowledge & expertise with multiple jurisdictions

Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word

Exceptional communication (written and verbal), influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines

Strong problem-solving, analytical, organizational, and time management skills

Ability to take part in active strategic discussions

Ability to work independently and in a team environment

Willing and able to travel 25%

Bachelor's degree preferred; 10+ years direct experience in lieu of degree

Proper Adjuster Licenses in all applicable states