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Claims Manager - Healthcare Management Liability

Beazley Group | Chicago, IL, US, 60290

Posted an hour ago


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Description

General

Job Title: Claims Manager - Healthcare Management Liability

Division: Group Claims

Reports To: As per Beazley's organisation chart

Key Relationships: Claims staff, underwriters, insureds, brokers and service providers

Job Summary: To help achieve the Beazley vision of being the highest performing specialist insurer. This will be done through the proactive management of claims, at the individual and portfolio level, to optimise spend and achieve high levels of satisfaction for the insured and broker through high quality claim management, resolution and excellent client service.

Individual Claims Leadership

  • Manage individual claims on a proactive basis from notification to closure, investing the necessary level of involvement required for each claim depending on the nature, category, maturity, type,
    and quantum of the claim.
  • Manage portfolio of Category 2 and some Category 1 claims (i.e., claims with an expected or actual value in excess of $250,000) including (depending on training and agreement of the Head
    of) Coverage Litigation but without allegations of bad faith.
  • Adhere at all times to Beazley's Claims Reserving Philosophy and Standards.
  • Develop, iterate, document, and execute claims strategies taking into account uncertainties, key decisions, potential outcomes, and estimated associated costs.
  • Understand and implement Beazley's Conduct Risk Policy.

Claims Portfolio Management

Manage a claims portfolio to optimise performance including the:

  • Review of individual claims within the portfolio on a regular basis and ensuring reserves and claims records are maintained in a timely manner as required by Beazley's claims controls
    and standards.
  • Identification of issues and trends in the portfolio, consult management/peers if required, and take appropriate and/or corrective action.
  • Communication of any material claims to Reinsurance and Finance as set out by the applicable claims authority, claims protocols, and procedures.
  • Working with Reinsurance to effect claims recoveries.

Strategy and Business Planning

  • Maintain an awareness of the overall strategic objectives and business plans of the Beazley claims function to the degree required to identify gaps or future opportunities to Claims
    Management.

Working with Underwriters

  • Develop an understanding of marketing and underwriting strategies for the respective business area.
  • Contribute to business development and renewal opportunities through attending client meetings to provide inputs regarding the Beazley claims philosophy and claims handling approach.
    Provide inputs to client meetings regarding specific claims issues.
  • Provide input to underwriters on review of potential or existing insured's claims experience.
  • Identify claims trends and developments and communicate their potential impact on the book.
  • Identify wordings issues and suggest policy wording improvements.

Authority & Minimum Standards Observance

  • Operate within approved claims authorities at all times.
  • Maintain a thorough knowledge of industry regulations and minimum standards.
  • Ensure compliance with the regulations and Beazley's claims control standards and protocols.

Third Party Management

  • Adhere to Beazley's procedures for the selection and retention of 3rd party professionals and manage relationships to the benefit of Beazley.
  • Hold overall ownership and accountability for delegated relationships as needed including appropriately managing escalation of items from delegated partners.
  • Review TPA performance data consistency with claims service requirements, claims best practices, and financial goals on a periodic basis.
  • Conduct file reviews or audits as required, and resolve any issues identified.
  • Provide feedback on a regular and proactive basis regarding the claim actions undertaken by the Third-Party Administrator (TPA).
  • Propose strategies for future claims handling, review case reserve adequacy, and ensure the TPA remains focused on claim finalisation.

Broker and Insured Relations

  • Work proactively to develop and manage strong relations with key brokers and insureds.
  • Promote the Beazley brand of excellence and professionalism in client service.

Operational

  • Ensure the management of claims conforms to the agreed standardised processes and use of share service functions as appropriate.
  • Contribute to the commitment to, and active development of a continuous improvement culture within the overall claims function.
  • Support the Claims Business Management Team and Claims Solutions Team to identify and implement business performance improvement opportunities.
  • Development and Mentoring of Junior Staff
  • Assist claims management and peers to develop, mentor and empower junior staff.
  • Ensure junior staff in the business unit have the knowledge and skills necessary to perform effectively in their given roles and responsibilities and increase their versatility for the broader
    Beazley business.
  • Serve as a positive role model for junior staff.

Conflicts of Interest

  • Adhere to Beazley's Conflicts of Interest policy, alert the appropriate person to any potential conflicts of interest, and take steps to resolve them promptly.
  • Immediately advise your Head of or Group Head of Claims if any Beazley employee seeks to exert undue influence on you or any other team member to act improperly in the management, reserving, or settlement of any claim.

General

  • Leverage networking opportunities within the business to develop standardised underwriting policy and best practice within Beazley.
  • Develop best practice and disseminate business and class knowledge within the Environmental, PEMA and Specialty Risks teams.
  • Work with peers within Environmental, PEMA and Specialty Risks to maximise business opportunities and profitability within the department. This will include but not be limited to sharing market information, marketing sources and cross selling opportunities.
  • Share and gather knowledge within the Beazley Group to ensure dissemination of best practice and maximise business opportunities and profitability across the Group.
  • Production of presentations and marketing literature as required.
  • Production of business plans/research documents for the Environmental account as required.

It is important that within all your interactions both internally and externally you adhere to Beazley's core values - Being Bold, Striving for Better, and Doing the Right Thing - as they contribute to an internal environment of teamwork and promote a positive brand image and experience to our external customers. We also expect Beazley employees to:

  • Comply with Beazley procedures, policies and regulations including the code of conduct, which incorporates the PRA and FCA Conduct.
  • Undertake training on Beazley policies and procedures as delivered by your line manager, the Culture & People or assurance teams (compliance, risk, internal audit) either directly, via e-learning or the learning management system.
  • Display business ethics that uphold the interests of all our customers.
  • Ensure all interactions with customers are focused on delivering a fair outcome, including having the right products for their needs.
  • Comply with any specific responsibilities necessary for your role as outlined by your line manager, the Culture & People or assurance teams (compliance, risk, internal audit) and ensure you keep up to date with developments in these areas. This may include, amongst others, Beazley's underwriting control standards, Beazley's claims control standards, other Beazley standards and customer relationship management.
  • Carry out additional responsibilities as individually notified, either through your objectives or through the learning management system. These may include membership of any Beazley committees or working groups.

Education and Qualifications

  • Graduate Calibre
  • Adjuster license(s) may be required as part of your job responsibilities. If required, those licenses must be obtained within the first 90 days of your employment and in accordance with an individual licensing plan established by Beazley Compliance and your Manager.

Skills and Abilities

  • Analytical skills: Problem solving (broad-based, analytical, conceptual, creativity), Analysis of financial statements, Financial assessments of claims, Data analysis, Decision-making
  • Work management skills: Time and workload management, Self-starter, Planning, Achievement orientation, Productivity focus
  • Interpersonal skills: Ability to influence others, Client and broker management skills, Purposeful communication, Flexibility, Active listening

Knowledge and Experience

  • Legal training or past claims experience establishing liability and/or settlement resolutions.
  • Functional knowledge & understanding: Claims management process, US/RoW Insurance market (general & focus group), US/RoW legal and regulatory environment, Alternative resolution approaches
  • Experience handling claims for Architects & Engineer. Including construction defects or design professional liability

Aptitude and Disposition

  • Outcome focussed, self-motivated, flexible and enthusiastic
  • Professional approach to successfully interact with senior management/ colleagues/ external suppliers
  • Diplomatic

Competencies

  • Problem-solving
  • Decisiveness
  • Customer-focused
  • Influencing others
  • Attention to detail
  • Team work
  • Self-starter
  • Analytical thinking
  • Managing resources effectively
  • Technical competency and expertise

The rewards:

  • The opportunity to connect and build long-lasting professional relationships while advancing your career with a growing, dynamic organization
  • Attractive base compensation and discretionary performance related annual bonus
  • Competitively priced medical, dental and vision insurance
  • Company paid life, and short- and long-term disability insurance
  • 401(k) plan with 5% company match and immediate vesting
  • 22 days annual PTO (full-time, prorated for 1st calendar year of employment), plus paid public holidays with the ability to flex the religious bank holidays to suit your religious beliefs. Additional PTO purchase is available up to a maximum of 5 days per calendar year.
  • Up to $700 reimbursement towards home office setup
  • Free in-office lunch, travel reimbursement for travel to office, and monthly lifestyle allowance in support of your wellbeing
  • The opportunity to save for, and purchase, shares of Beazley stock
  • Six months fully paid parental leave, regardless of how you come to parenthood
  • Company paid sabbatical up to 12 weeks after 10 years of continued service
  • Support with exam/study leave and fees for relevant qualifications related to furthering education
  • Up to 2.5 days matched paid leave for volunteering at a charity of your choice and 5 days paid leave to provide or arrange care for a dependent with a long term care need annually
  • Smart working policy and flexible working culture, trusting our employees to do what works best for them, their role and the needs of the business

Salary for this role will be tailored to the successful individual's location and experience. The expected compensation range for this position is 145k - 155k per year plus discretionary annual bonus. You will be able to discuss your salary expectations should you be contacted about this role.


Responsibilities

Individual Claims Leadership

  • Proactively manage individual claims from notification to closure, investing the necessary level of involvement required for each claim depending on, inter alia, the nature, category, maturity, type and quantum of the claim.
  • Follow at all times Beazley's Claims Reserving Philosophy and Claims Standards.
  • Develop, iterate, document and execute claims strategies taking into account uncertainties, key decisions, potential outcomes and estimated associated costs.
  • Understand and implement Beazley's "Treating Customers Fairly" policy.

Claims Portfolio Management

Manage claims portfolio(s) to optimise performance including:

  • Regularly review individual claims within the portfolio and keep reserves and records up to date as required by Beazley's claims controls and standards.
  • Identify issues and trends in the portfolio and take appropriate and/or corrective action.
  • Keep Reinsurance and Finance advised of any material claims as set out in your claims authority and claims protocols and procedures and work with Reinsurance to effect recoveries.

Working with Underwriters

  • Develop an understanding of marketing and underwriting strategies for your business area and contribute to business development and renewal opportunities by attending client meetings to explain the Beazley claims philosophy and approach to claims handling, and discussing any claims issues.
  • Provide input to underwriters on review of potential or existing insured's claims experience.
  • Feedback claims trends and developments and their potential impact on the book.
  • Suggest wordings improvements.

Authority & Minimum Standards Observance

  • Operate within your approved claims authority at all times.
  • Have thorough knowledge of industry regulations and minimum standards to ensure compliance with the regulations and Beazley's claims and underwriting control standards and protocols.

Third party Management

  • Follow Beazley's procedures for the selection and retention of 3rd party professionals and manage these relationships to the benefit of Beazley.
  • Where required conduct file reviews or audits and resolve any issues identified.

Broker and Insured Relations

  • Work proactively to develop and manage strong relations with key brokers and insureds.
  • Promote the Beazley brand of excellence and professionalism in client service.

Conflicts of Interest

  • Adhere to Beazley's Conflicts of Interest policy, alert the appropriate person to any potential conflicts of interest and take steps to resolve them promptly.
  • Immediately advise your Claims Team leader or Group Head of Claims if any Beazley employee seeks to exert undue influence on you or any other team member to act improperly in the management, reserving or settlement of any claim.

Person Specifications

Skills and Abilities

  • Analytical skills: Problem solving (broad-based, analytical, conceptual, creativity), Analysis of financial statements, Financial assessments of claims, Data analysis, Decision-making
  • Work management skills: Time and workload management, Self-starter, Planning, Achievement orientation, Productivity focus
  • Interpersonal skills: Ability to influence others, Client and broker management skills, Purposeful communication, Flexibility, Active listening

Knowledge and Experience

  • Functional knowledge & understanding: Claims management process, US/RoW Insurance market (general & focus group), US legal and regulatory environment, Alternative resolution approaches

Aptitude and Disposition

  • Outcome focussed, self-motivated, flexible and enthusiastic
  • Professional approach to successfully interact with senior management/ colleagues/ external suppliers
  • Diplomatic

Competencies

  • Problem-solving
  • Decisiveness
  • Customer-focused
  • Influencing others
  • Attention to detail
  • Team work
  • Self-starter
  • Analytical thinking
  • Managing resources effectively
  • Technical competency and expertise
View more..