TPA Claim Director - Auto Liability

TPA CLAIM DIRECTOR –  Auto Liability

Position Reports to:

Vice President – Auto TPA Management

Role can be based in our Dallas, TX, Scottsdale, AZ or Atlanta, GA office.

Job Summary:

The TPA Claim Director is the person accountable to HIIG for the performance of the TPA claim staff handling automobile claims on behalf of HIIG, its policyholders and insureds. The role is responsible for ensuring that the segment of claims under his/her purview are managed in accordance with HIIG claim handling requirements and standards, all applicable state and regulatory requirements, and meet or exceed HIIG’s expectations in the quality of the overall claim outcomes achieved.

The TPA Claim Director oversees the handling of all heavy equipment transportation and auto liability claims, both claims that fall within the level of authority delegated to the TPA as well as claims that exceed that level of authority.  The TPA Claim Director reviews reserve increases, provides guidance and input on investigation, claims management activities, litigation management and reviews claims strategically for purposes of resolution.  In addition, a key element of the role is the effective management of claim related expenses by ensuring the TPA’s compliance with use of HIIG preferred claims service providers, e g: investigators, attorneys, etc.

Essential Responsibilities:

To oversee and direct the claim handling activities of TPA staff as may be necessary to ensure timely and appropriate claim investigation, effective management of the claim, adherence to claim handling requirements and practices, credible assessment of exposure reflected in case reserves, and prompt and fair resolution of the claim when and where possible.

• Manages relationship with Third Party Administrator staff handling the claims within his/her purview and ensures their understanding of HIIG claim handling requirements and performance expectations
• Directs the activities of the TPA and counsel providing input and direction as required.
• Conducts continuous review and oversight of claims managed by the TPA for purposes of:
• Ensuring that claims are handled effectively, evaluated quickly
• Case reserves appropriately reflect likely outcome
• Identifying any performance issues and compliance gaps and taking actions necessary to remediate.

• Actively monitors, manages and seeks to resolve claims that exceed the TPA’s delegated authority 
• Ensures all open claims are effectively brought to resolution at the best possible outcome at the earliest opportunity.
• Identifies and evaluates additional opportunities to further reduce the severity and cost of claims
• Conducts analysis relating to understand the activity and ‘behavior’ of the claim population(s) under management and reports as required.
• Identify and pursue subrogation opportunities as they arise.

Qualifications:

This TPA Claim Director role requires a depth of heavy equipment transportation and auto liability claims ‘technical’ knowledge and experience in managing such claims subject to the regulations and requirements set forth by the State Authorities governing such matters in each State where the claim is domiciled.

• Minimum of 8 years of experience to include direct handling of Auto Liability claims
• Some tenure in a supervisory or other leadership role managing claim handling staff 
• Has demonstrated high level of understanding of individual state and civil laws, claims practices and regulatory requirements.
• Proven ability to direct and maintain a high level of claims management performance, quality and compliance.
• Strong analytical and organizational skills
• Excellent influencing and negotiation skills; proven ability to collaborate and build relationships across teams stakeholders and providers
• Flexibility to travel

Professional Attributes:

• Able to manage, motivate and develop people
• Strong team building, influencing and negotiation skills
• Utilize specialized computer software applications. Document case histories, reports and letters
• Demonstrate effective written and verbal communication skills
• Evaluate and rate permanent disability cases
• Work independently and demonstrate good business sense
• Results oriented. A strong focus on execution and getting things done right.
• A self-starter with a high level of professional maturity and a strong sense of urgency
• Comfortable and effective working in an entrepreneurial environment. 
• Thrives on and is not afraid of challenges
• Ability to establish and maintain effective working relationships with peers, staff and other functional areas. 
• Ability to identify and develop talent, delegate clearly and appropriately
• Ability to drive results by identifying and resolving significant problems within the scope of responsibility

Education

• Bachelor Degree Required
• Certifications: Associate in Risk Management; Claim Management or other related industry designation
• Licenses: Current state adjusting license, a plus.

Working Conditions/Physical Demands:

Work environment characteristics and physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Candidates who cannot perform some or all of these duties because of disabilities will nevertheless receive full consideration for the job based on their ability to perform essential duties and responsibilities.

While performing the duties of this job, the employee is not exposed to weather conditions and the noise level in the work environment is usually moderate.  While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear.  The employee is

occasionally required to stand and walk.  The employee must frequently lift and/or move up to 20 pounds.  Specific vision abilities required by this job include close vision, distance vision, depth perception, and ability to adjust focus.

This job description does not necessarily list all the duties of the job.  Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.  This job description is not a contract for employment, and either you or the company may terminate employment at any time, for any reason.