Supervises assigned claims team and reviews claim files to ensure completeness, accuracy, and appropriate fact development.
Assigns claims to handlers based on complexity, skills, and experience, and provides strategic guidance on coverage, compensability, liability, claim valuation, negotiation, and resolution.
Reviews and approves reservation of rights and denial letters; assigns or assists with selection of defense counsel and monitors litigated matters.
Ensures timely and appropriate reserving in compliance with client contracts, company guidelines, authority levels, and regulatory requirements.
Ensures claims are handled in accordance with best practices, good‑faith standards, client special handling instructions, and claims philosophy, including proper file documentation.
Oversees team workload, productivity, and performance; monitors dashboards, scorecards, and key performance metrics.
Conducts file audits, identifies improvement opportunities, and implements action plans.
Establishes performance goals, conducts performance reviews, provides coaching, and addresses disciplinary issues as needed.
Interviews, hires, and manages compensation recommendations; develops team expertise and supports succession planning through talent identification and development plans.
Builds and maintains strong relationships with clients, agents, brokers, and internal stakeholders through proactive communication and client visits.
Requirements
Bachelor’s degree, preferably in insurance, or equivalent relevant experience
Eight years of claims adjusting experience, including experience with large and complex claims
Strong understanding of workers' compensation preferred
Attainment of all applicable state licenses within six months of hire
Prior leadership or supervisory experience preferred
Prior experience with a third party administrator (TPA) preferred
Insurance industry coursework (e.g. INS, AIC, CPCU) preferred Benefits
Outstanding benefits with life, medical, dental, vision and prescription drug coverage
Competitive paid time off plan and a full day of volunteer time off annually
Financial incentives, including a 401(k) plan match, pension plan, OneEMC bonus plan and recognition and anniversary awards
Professional development and growth opportunities, including tuition reimbursement
Wellness initiatives to improve team member well-being and reduce health insurance costs
Flexibility to dress for your day and opportunities for alternative work arrangements Apply To this Job