Job Title:   Complex Claims Unit Leader
03 / 31 / 2013
Indianapolis
IN
Yes

JOB DESCRIPTION:

JOB SUMMARY:           Assists in the execution of the strategic direction of casualty complex claims.  Leads casualty complex claims specialists, responsible for the appropriate resolution of complex casualty claims having a significant financial impact and/or producing high corporate visibility.    Is member of the casualty complex claims leadership team and recognized technical subject matter expert (SME) in casualty complex claims.
 
 A.  ESSENTIAL FUNCTIONS(Listed in order of importance, frequency or sequence, 1=most important/frequent, etc.).

 
 

  1. Strategy Execution - Responsible for assisting in execution of the strategic direction of the complex claims casualty line of business as approved by National Casualty Claims Leader.  Ensures adherence to compliance standards and may direct reinsurance activities.  Is member of the casualty complex claims leadership team and recognized technical subject matter expert (SME) in casualty complex claims. 
  2. People Leadership - Leads assigned casualty complex claims specialists, including employee selection, employee-related issues, work quality, customer service, employee morale and work environment, performance evaluation, work assignments, establishing reserves, reviewing files, and coaching in technical and career development.  Directly manages a team of casualty complex claims specialists with technical expertise and without any regard to geographic location.
  3. Referred File Supervision - Responsible for Westfield’s largest and most complex claims, including direct or indirect supervision of activities surrounding the adjustment and resolution of Westfield’s casualty referred claim files typically in excess of $250,000.  Responsible for the appropriate resolution of complex claims having a significant financial impact and/or producing high corporate visibility and without any regard to geographic location, size or type of casualty claim.
  4. File Exposure Analysis - Participates in complex and large exposure analysis and strategies through roundtable discussions with home office and field operations.
  5. Claim File Handling - May directly handle Westfield’s largest and most complex claims, typically in excess of $250,000.  Responsible for the appropriate resolution of assigned complex claims having a significant financial impact and/or producing high corporate visibility and without any regard to geographic location, size or type of casualty claim.
  6. SME - Serves as casualty complex claims technical consultant to business partners, Quality Assurance & Compliance, and related industry groups to identify and communicate reserving and industry activity and trends and to update claims management process, programs and tools.  Participates in policy language creation and review, selection of vendors, selection of new markets and selection of product enhancements. 
  7. Legislation - Assists with analysis and timely communication of strategies, processes, and changes in the claims, legal, and legislative environment.  Participates in the creation, review, and approval of Claims Status Reports. 
  8. Communication - Maintains effective and ongoing communication with claims staff, internal and external business partners, project team members, claims leadership, and vendors.  May serve as a subject matter expert to the various business units regarding casualty complex claims.
  9. Customer Service - Ensures customer service excellence.  Responsible for the customer, agent and claims professional experience associated with casualty complex claims.
  10. Data Analysis - Gathers, organizes and analyzes performance data and results to identify and report performance, trends, and opportunities; makes recommendations regarding areas of improvement. Creates reports and communicates results with claims leadership, agents, and business partners.
  11. Industry Best Practices - Participates in professional industry groups and stays abreast of industry changes and advancements to communicate, develop, and incorporate best practices into the claims business.  Shares new information, best practices, and processes.  
  12. Collaboration - Partners with various business units and corporate cross-functional teams (Underwriting, Risk Services, Westfield University, R&D, Claims Legal, etc.) to develop, implement, train and manage various line of business claims initiatives and programs to improve unit, department, and company performance.
  13. Leader Assistance - May assist leader with data analysis, risk identification, business planning, processes and budget; is accountable for expenditures of the department.
  14. Reinsurance Reporting - Reports claims that are within reinsurance and errors and omissions agreements, and pursues reimbursement.  Prepares detailed reports for senior management and reinsurers.
  15. Training - Collaborates with casualty management team in the identification of casualty training needs.  May partner with Westfield University to design, develop, and deliver training programs to claims professionals.
  16. Performs other duties as assigned.
  17. Transitional - Due to the nature of the reorganization resulting in this job title, the person filling this job title may be required to perform some of the essential functions of another job description during the transition period.

 
B.  JOB SPECIFICATIONS/EXPERIENCE/CERTIFICATION/EDUCATION (in order of importance):
 

  1. 7 or more years of casualty claims handling experience of accurately evaluating, negotiating, and settling casualty claims of all severity levels.  Demonstrated technical expertise in casualty claims.
  2. 3 or more years of experience supervising or regularly handling complex casualty claims (potential exposures in excess of $250,000 or specialty areas).
  3. 3-5 years of successful leadership experience with increased responsibility.  Experience coaching and developing direct or indirect reports with proven results.
  4. Excellent oral, written and interpersonal skills, resulting in the ability to interact with all levels of management and employee population.
  5. Excellent analytical, tracking, and monitoring skills.  Ability to collect and analyze data, identify trends, establish facts, and recommend solutions.
  6. Strong organization and facilitation skills.
  7. Proficient use of various core systems, office and computer equipment and software packages.
  8. Conflict resolution experience.
  9. Travel.
  10. Valid driver’s license and a driving record that conforms to company standards.
  11. Industry recognized designation, such as CPCU, SCLA, AIC, etc.
  12. Bachelor’s Degree.

 
C. PHYSICAL REQUIREMENTS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. 
 

  1. Ability to work effectively in an office environment for 40+ hours per week (including sitting, standing and working on a computer for extended periods of time).
  2. Ability to communicate effectively in a collaborative work environment utilizing various technologies such as:  telephone, computer, web, voice, teleconferencing, e-mail etc.
  3. Ability to travel as required.
  4. Ability to operate an automobile within the parameters of the driving policy.

 
D.  SUPERVISES:
 

  1. Specialists - Casualty Complex Claims
  2.  Administrative Support Staff
 

 

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