Claim Director-TPA Oversight at Chubb

Posted in General Business 22 days ago.

Type: Full-Time
Location: Whitehouse Station, New Jersey





Job Description:

JOB DESCRIPTION

Perform assignments, tasks or activities that contribute to the overall business objectives of the corporation and the business divisions being supported. Develop and maintain strong internal and external customer relationships in an effort to increase profitability and productivity with an emphasis on providing a world class claims experience. Maintain proactive management of claims by focusing efforts toward expedient and equitable resolutions and insuring reserves are established to reflect the full exposure on the claims which are being reviewed. Provide timely and appropriate direction and authority to all Third-Party Administrators (TPA). Track and determine unfavorable claim trends and develop an action plan with the TPA to address and execute on corrective action.

Key Responsibilities:


  • Establish strong relationships with all TPAs in your pending.
  • Oversight management of approximately 150 claims
  • Provide direction, reserve, and settlement authority to TPA claim handlers as outlined in the TPA Shadow Protocol within the Director's authority and elevating requests above authority to appropriate management levels for approval.
  • Perform assignments, tasks or activities that contribute to the overall objectives of the business division being supported including but not limited to, conducting audits, providing financial analysis on reserve adequacy, identifying occupational disease exposures, and providing expertise on jurisdictional nuances.
  • Work closely with other Chubb disciplines in a team environment consisting of underwriting, actuarial, legal, and accounting.
  • Ensure all recovery opportunities are identified, investigated, and explored
  • Participate in the assigned rotation of the Claim Loss Report (CLR) Committee to discuss complex claims
  • Identify trends to determine individual or office weaknesses of designated TPA and/or regions and develop action plans to correct negative trends and establish monitoring methods to ensure action plans have been successfully implemented.
  • Responsible for implementation, monitoring and reporting on results of assigned special projects
  • Participation in jurisdictional or procedural training by Chubb North American Claims
  • Obtain the necessary CEU's to maintain your current licenses
  • Facilitate training for emerging jurisdictional or procedural issues
  • Demonstrate skills in the following competencies: Strategic leadership, Business Acumen, Orientation to Results, Influencing Outcomes, and Focus on Development
  • Have an excellent understanding and demonstrated ability to apply the technical aspects of claim handling
  • Effectively evaluate programs and procedures for continuous improvements
  • Travel as necessary

If you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure.

QUALIFICATIONS


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.





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