ESIS Claims Team Leader, AGL

ESIS Claims Team Leader AGL

Key Objective:
Leads and oversees the activities of Claims Representatives in the investigation and resolution of claims to ensure prompt efficient and equitable claims services.

Major Duties & Responsibilities:

• Reviews initial notice of claim assesses coverage validity and determines eligibility for streamlined processes. Identifies appropriate actions in cases of questionable coverage or absence of coverage.
• Assigns tasks to Claims Representatives and delegates settlement authority in collaboration with the Claims Vice President or Unit Manager. Retains higher settlement authority for complex cases and may directly resolve such claims. Refers cases beyond scope of authority to Unit Managers.
• Supervises investigations and monitors the resolution or disposition of claims ensuring timely contact with insureds and claimants thorough investigations and fair settlements.
• Establishes loss reserves to reflect probable organizational obligations and reviews or adjusts reserves as necessary.
• May directly resolve claims based on office size territory and workload. Evaluates the work of Claims Representatives on open cases or at regular intervals providing guidance and identifying areas for improvement.
• Initiates subrogation or recovery proceedings as appropriate. For cases in litigation collaborates with Claims Attorneys and directs their activities. Negotiates and authorizes settlements.
• Participates in human resources processes for team members including conducting performance evaluations implementing training and development programs and supporting career growth. Engages in salary administration and oversees recruitment and staffing for the unit as vacancies arise.

EXPERIENCE AND EDUCATION

• Extensive technical expertise in claims management demonstrated by a minimum of 7 years of claims handling experience.
• Experience managing claims across multiple jurisdictions with the appropriate Adjuster Licenses preferred.
• Proven ability to plan organize and implement general business and team management practices supported by successful completion of management and technical programs college-level coursework or equivalent practical work experience.
• Skilled in leading change by addressing resistance at both the team and individual levels with the ability to independently evaluate and implement claims management best practices through coaching training and mentoring.
• Strong understanding of team-building principles and continuous quality improvement techniques and their application to ongoing processes and activities.
• Effective leadership abilities including coaching developing and guiding team members to achieve goals and objectives.
• Excellent communication negotiation and interpersonal skills to engage effectively with individuals at all levels of an organization both internally and externally.
• Strong analytical and problem-solving skills.
• Demonstrated commitment to delivering consistent high-quality service to customers.
• Serves as a role model within the team or office taking initiative on challenging tasks and holding oneself and others accountable to high standards of performance and professionalism.