AVP TPA Claims
AVP TPA Claims
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Salary Not Disclosed
1 Vacancy
Job Description
At Coaction were a unique mix of leaders achievers thinkers and team players with a highperformance mindset and a diverse skillset. We bring our industry expertise together to continually push the boundaries of what insurance can be for our clients.
At Co/Action were a unique mix of leaders achievers thinkers and team players with a highperformance mindset and diverse skill set. We bring our industry expertise together to continually push the boundaries of what insurance can be for our clients.
We are seeking an AVP TPA Claims to join our ThirdParty Administrator (TPA) Claims Team in either our Morristown New Jersey Glendale California or New York City location. The TPA Claims AVP will be responsible for the daytoday management of the internal TPA team assisting in all aspects of the claim operation for the TPA programs and operations. The AVP of TPA Claims is responsible to develop and oversee TPA program protocols and guidelines and this role will also support the development of our claims department by providing strategic insight and identifying areas of improvement throughout the business while conducting training and support on complex claims issues.
Key Responsibilities:
- Oversee and manage the internal TPA claim management team and the claim inventory for TPA partners across multiple lines including auto workers compensation property and legacy claims.
- Develop implement and enforce claims handling protocols and best practices to ensure highquality service and outcomes across TPA programs.
- Cultivate and maintain strong relationships with underwriters and brokers to tailor claimshandling approaches to meet client needs.
- Ensure TPA compliance with coverage evaluations authority levels staffing metrics and litigation management; monitor prompt quality investigations timely reserving and claim resolutions.
- Oversee the tracking and evaluation of TPA performance through onsite or virtual operational and best practice audits coordination with Co/Action technical claim audit team and TPA key claim performance metrics.
- Oversee TPA remediation activities/action plans as necessary to address performance.
- Collaborate with business units to identify and mitigate risks associated with thirdparty vendors while exploring opportunities for improvement.
- Work with Underwriting and Program Managers (MGAs MGUs) to secure renewals and new business opportunities for unbundled business through the use/approval of TPAs.
- Prepare and maintain documentation for TPAs including contracts policies procedures and reporting protocols.
- Recruit and develop quality staff setting goals and objectives aligned with the corporate strategy.
- Conduct training sessions on thirdparty risk management programs and policies to ensure firmwide compliance and understanding.
- Work closely with the Legal department to effectively manage contracts with thirdparty vendors.
- Prepare and deliver monthly and quarterly management reports and metrics to senior leadership.
- Monitor and control departmental expenses while balancing staff caseloads.
QUALIFICATIONS:
- 10 years of experience in Claim Management.
- 57 years of TPA management experience.
- Bachelors degree preferred
- Strong claims and claims operational background.
- Strong understanding of the insurance industry/market
- A record of providing outstanding claim service and customer service experience
- Excellent verbal and written communication skills with strong influencing communication skills
- Experience in conflict resolution and strong negotiation skills
- Results oriented and ability to think strategically.
- Excellent organizational skills and flexibility managing and tracking projects.
- Enthusiastic reliable and collaborative leader.
- Strong focus on problem solving and demonstrated commitment to teamwork/team development
- Experience leading and influencing others through change
- Demonstrates leadership skills to manage and drive solutions
- Relationship/Partnership/Account management background a plus
- Proficiency with MS Office software Excel and PowerPoint
- Strong verbal and written communication skills
- Familiarity with contract management and legal aspects of vendor relationships is a plus.
* *This is not available as a fully remote employment. Interested candidates must be willing to work on a hybrid work schedule**
Equal Opportunity Employer
Coaction is an Equal Employment Opportunity employer. Coactions policy is not to discriminate against any applicant or employee based on race color religion national origin gender age sexual orientation gender identity or expression marital status mental or physical disability and genetic information or any other basis protected by applicable law. Coaction also prohibits harassment of applicants or employees based on any of these protected categories.
If your application is selected you will receive an email directly from the Coaction Recruiting Team at asking you to contact a member of the Coaction Recruiting Team. Any other method of contact may be fraudulent.
Required Experience:
Exec
Employment Type
Full-Time
