Claims Supervisor presso Acrisure

Job Description

GENERAL DESCRIPTION

The Claims Supervisor is responsible for the management and oversight of a dedicated claim unit in a manner that ensures the highest levels of customer service and job satisfaction.

ESSENTIAL FUNCTIONS

• Manage a dedicated claim unit in a manner where superior service is provided in accordance with Midwest Best Practices, good faith settlement practices and program management requirements.
• Ensures claim unit compliance with all applicable State and Federal regulations where team members effectively apply requirements to claim activities and documentation.  
• Utilize effective techniques over screening, interviewing, and hiring decisions where qualified candidates are suitable for each job role with an entrepreneurial-minded, career-oriented focus. 
• Continually develop team members in accordance with policy and set quarterly individual Objectives for Learning. Work with the Director of Learning & Development for continuous improvement around learning gaps. Effectively manage staff authority levels with the Director of Learning & Development commensurate with experience.
• In accordance with the annual appraisal process, ensure the timely complete of individual performance reviews for all claim unit team members, providing an appropriate merit increase and salary recommendation. 
• Ensure that team members adhere to account service and special handling requirements to achieve high level CRM. Proactively handle complaints in accordance with policy to achieve desired customer outcomes and conflict resolution. 
• Triage new loss assignments where evenly distributed within the claim unit and provide effective guidance and direction in the notes. Review and approve claims that require conversion to and from medical/indemnity. In practice, we should maintain standard caseloads of 125 per indemnity and 150 per medical-only desk, through full staffing and adherence to minimum closing productivity standards. 
• Ensure that claims team members adhere to timely and thorough investigations.  
• Oversee timely setting of reserves to Ultimate Probable Cost (UPC).  Review and approve reserves subject to supervisory authority limits.  
• Review and approve settlement authority within supervisory limits and provide effective negotiation strategies.
• Oversee subrogation claims within authority limits.
• Approve claim coverage and compensability denials, as well as file closures.
• Ensure that all team members adhere to effective diary standards and timely review of new mail tasks, as well as prompt responses to emails. 
• Review of benefit and State form escalation tasks for timely delivery, compliance and reduced self-imposed penalties.
• Reduce the overall amount of indemnity overpayments through timely wage calculations and effective disability management oversight. 
• Complete 45-day and 90-day audits within 30-days of the task due date, where action items promote effective strategies and direction.
• Utilization of the PS dashboard and predictors for effective decision making, accuracy of reserving estimates and/or adjustments to development, recoveries and closing targets.
• Provide feedback to  management and Executive Claims over the effectiveness of vendor performance on the approved panel. 
• Maintains that claims team members adhere to our Data Calls – Claims Statistical Data Entry Policy, where data fields are entered at the highest level of accuracy.
• Produce management reports and complete 45-day and 90 day technical audits within 30-days of the task due date.   
• Handle a caseload of 10-15 Serious/CAT claims.  
• Other duties and projects as assigned.

Approve claim coverage and compensability denials, as well as file closures. Ensure that all team members adhere to effective diary standards and timely review of new mail tasks, as well as prompt responses to emails.  Review of benefit and State form escalation tasks for timely delivery, compliance and reduced self-imposed penalties. Reduce the overall amount of indemnity overpayments through timely wage calculations and effective disability management oversight.  Complete 45-day and 90-day audits within 30-days of the task due date, where action items promote effective strategies and direction. Utilization of the PS dashboard and predictors for effective decision making, accuracy of reserving estimates and/or adjustments to development, recoveries and closing targets. Provide feedback to  management and Executive Claims over the effectiveness of vendor performance on the approved panel.  Maintains that claims team members adhere to our Data Calls – Claims Statistical Data Entry Policy, where data fields are entered at the highest level of accuracy. Produce management reports and complete 45-day and 90 day technical audits within 30-days of the task due date.    Handle a caseload of 10-15 Serious/CAT claims.   Other duties and projects as assigned.

COMPETENCIES/QUALIFICATIONS

• Candidate must possess strong communication, written, interpersonal, analytical, and organizational skills. 
•   Strong ability to execute detailed verbal and written instructions and respond effectively and efficiently. 
• Readily control/handle problem issues in times of stress and in a climate of conflict and/or adversity
• Candidate should have a strong ability to review and analyze data and make sound decisions based upon that analysis.
• Strong knowledge of workers’ compensation claims procedures, policies, technology, state and federal law regarding insurance and the elements of intent, material misrepresentation, evidence, and restitution.  
• Responsiveness to changing business needs and the ability to multi-task.   Ability to take direction and make decisions.
• Candidate should have the ability to work well as part of a team and independently with limited supervision. 
• Ability to adhere to the code of ethical conduct and engage in fair claim settlement practice.
• Strong computer skills including Microsoft Office Suite and ability to work with investigative databases and jurisdictional reporting requirements. 

Minimum Education:

• Bachelor’s degree and/or 8 or more years relevant experience is required.
• Litigation experience is preferred.
• Prefer relevant state licensing or ability to gain licensing is required.  
• 2+ years of supervisory experience is preferred.  

Pay Details:

The base compensation range for this position is $80,000 - $98,138. This range reflects Acrisure's good faith estimate at the time of this posting. Placement within the range will be based on a variety of factors, including but not limited to skills, experience, qualifications, location, and internal equity.

Acrisure is committed to employing a diverse workforce. All applicants will be considered for employment without attention to race, color, religion, age, sex, sexual orientation, gender identity, national origin, veteran, or disability status.  California residents can learn more about our privacy practices for applicants by visiting the Acrisure California Applicant Privacy Policy available at www.Acrisure.com/privacy/caapplicant.

To Executive Search Firms & Staffing Agencies: Acrisure does not accept unsolicited resumes from any agencies that have not signed a mutual service agreement. All unsolicited resumes will be considered Acrisure’s property, and Acrisure will not be obligated to pay a referral fee. This includes resumes submitted directly to Hiring Managers without contacting Acrisure’s Human Resources Talent Department.

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