ESIS ProClaim Senior Manager at Chubb in Melville, New York

Job Description:

JOB DESCRIPTION

ESIS ProClaim is seeking an experienced Senior Claims Manager. In this role you will lead a team of professional healthcare liability claims adjusters.

Key Objective

Under the direction of the AVP and VP of Claims the Claims Team Leader will work with their direct reports in all aspects of third-party claim management. The Claims Team Leader will assist, guide, enable and develop the team in the assignment of new claims, coverage, investigates facts of third-party claims, secure evidence, assesses, addresses subrogation/recovery/tenders, apportions liability and settles claims at the best outcome within established claim best practices guidelines and client instructions.

Duties include but are not limited to:

• Supervise a claims team of professionals.
• Assign new claims with direction to the claims professional addressing: policy information to determine coverage, conducts a thorough investigation and may determine the extent of the policy's obligation to the insured depending on the line of business.
• Maintain diary system to ensure each file is reviewed at a minimum of every 90 days.
• Provides coaching and feeback to their direct reports.
• Develops, works and shares performance and productivity goals.
• Reviews, analyzes and shares performance results, productivity and audit/quality review results.
• Provides direction to claims professionals to be able to effectively work with defense counsel and litigation working collaboratively, as directed by the client.
• Works with assigned claims professionals to insure detailed 90-day Claim Summary Reports are prepared and provide updates to the client on investigation, potential settlement opportunities, claim denials, reservation of rights, third party tenders and recommendations to present at claims review meetings.
• Posts loss and expense reserves in Claims system within authority limits and recommends reserve changes above authority to AVP and/or VP of Claims.
• Reviews progress and status of claims with claims leadership and discusses issues/opportunities/task and remedial actions.
• Prepares and submits to claims leadership all unusual or potentially undesirable exposures such as allegations of bad faith or unfair claim practice allegations.
• Assists Claims Leadership in formulating improvements in claims handling procedures.
• Assist and works with Partnership Leaders on delivering results, attend meetings and claim reviews.
• Reviews and confirms claims professionals have secured the appropriate releases, proofs of loss or compensation agreements and issues company drafts in payments for claims.
• Maintains claims with the appropriate file notes, reports, photos, and documentation within the claim.
• Follows all company and regulatory compliance requirements.
• Updates claim timely with Medicare data and addresses Medicare reporting & interest.
• Meets or exceeds performance goals.

QUALIFICATIONS

• 10

  ABOUT US

  
  

  Chubb is a world leader in insurance. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.

  
  

  At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law. Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees. Chubb prohibits all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment.