Claims and Loss Performance Manager

Claims and Loss Performance Manager

The James Allen Companies Inc.

BASIC FUNCTION

Oversee and proactively manage TPA claims and loss performance. Responsible for impacting and improving the loss performance of the portfolio of programs. Includes oversight of TPA, analytics of loss data, interaction with Underwriting and implementing impactful loss control initiatives. This position will report directly to the Chief Underwriting Officer.

Oversight of TPA includes ensuring their proactive handling of claims, timely appropriate reserving practices and achieving optimal disposition of claims.

Analytics of loss data includes identifying loss trends, monitoring TPA performance, and monitoring overall program performance. This information should be consistently communicated to Underwriting and result in collaboration. Ultimately leading to improved risk selection and pricing.

This position will also be responsible for identifying loss control or risk management products and services that will help improve the overall performance of the program. These loss control needs should be identified through the management of the claims and loss analysis. Collaboration with underwriting should result in identification, implementation and a process to monitor the impact of these loss control initiatives.

PRIMARY DUTIES AND RESPONSIBILITIES

  • Proactive management of TPA handling claims.
  • Day to day oversight of TPA which includes and monitoring their adherence to Account Instructions, reserving, claim resolution and overall best practices.
  • Conduct periodic audits of TPA claim files.
  • Proactive oversight and management of TPA claims.
  • Analysis of TPA claims, exposure data and loss triangles. Includes identification of claim trends.
  • Provide feedback to program directors and underwriters of any emerging trends and specific claim issues.
  • Facilitate quarterly claim round tables with underwriting team.
  • Create monthly loss data reports for underwriting and management team.
  • Develop, maintain, and enhance relationship with carrier claims people.
  • Be a resource for our agents by responding to questions on coverage, claim status and claim handling.

· Identify, research, analyze and recommend loss control/risk management products for the company programs.

MINIMUM QUALIFICATIONS

· Bachelor’s degree from four-year college or university or equivalent work experience.

· Claims or Underwriting Designations a plus.

· 7-10 years + with carrier or TPA claims experience

· Underwriting, risk management or loss control experience a plus.

· Ability to run, manipulate and analyze claims data

· Multi-line claim background required with an expertise in Transportation/Commercial Auto. Should also have experience in Commercial General Liability, Property, and Umbrella/Excess.

· Superior written and verbal communication skills

· Strong attention to detail

· Proficiency with Microsoft Office Suite (Excel, Word, PowerPoint)

· Ability to travel out of state on occasion

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