索赔团队负责人，汽车
Claims Team Lead, Auto
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汽车理赔团队主管
职位主要职责：监督多个检查员和技术人员团队处理责任理赔；监控同事的工作量，提供培训，并监控个别理赔活动；为检查员在理赔裁决方面的报告提供技术/管辖权指导；并维护团队中理赔的日记，包括对复杂或高风险理赔的频繁记录。
核心职责可能包括：
- 监督多个检查员团队、多个产品线检查员和/或至少七名技术人员，负责广泛的控制范围；可将部分职责委托给团队内部其他人。
- 识别并建议管理层趋势、问题和事项以及推荐的行动方案；向管理层通报新流程和持续改进的想法；并与管理层协调办公室项目。
- 为检查员在理赔裁决方面的报告提供技术/管辖权指导。
- 汇编、审查并分析管理报告并采取适当行动。
- 对理赔进行质量审查，确保符合审计要求、服务合同要求和质量标准。
- 作为客户和索赔人针对特定理赔、程序性或特殊请求的申诉的第二级处理；执行申诉的最终处理决定。
- 审查高成本理赔和超出个人检查员权限的理赔的准备金金额。
- 监控第三方理赔；定期审查诉讼理赔、严重职业康复理赔、存疑理赔和由客户确定的敏感理赔。
- 与客户保持联系并促进专业客户关系；根据理赔状态向客户提供建议；并按客户要求提供特定理赔的书面摘要。
- 确保直属下属遵守相关要求
查看英文原文
By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies
Certified as a Great Place to Work®
Fortune Best Workplaces in Financial Services & Insurance
Claims Team Lead, Auto
PRIMARY PURPOSE OF THE ROLE: To supervise the operation of multiple teams of examiners and technical staff for liability claims for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims.
ESSENTIAL RESPONSIBLITIES MAY INCLUDE
- Supervises multiple teams of examiners, multiple product line examiners and/or several (minimum seven) technical operations colleagues for a wide span of control; may delegate some duties to others within the unit.
- Identifies and advises management of trends, problems, and issues as well as recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the office.
- Provides technical/jurisdictional direction to examiner reports on claims adjudication.
- Compiles reviews and analyzes management reports and takes appropriate action.
- Performs quality review on claims in compliance with audit requirements, service contract requirements, and quality standards.
- Acts as second level of appeal for client and claimant issues regarding claim specific, procedural or special requests; implements final disposition of the appeal.
- Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner.
- Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client.
- Maintains contact with the client on claims and promotes a professional client relationship; makes recommendations to client as suggested by the claim status; and provides written resumes of specific claims as requested by client.
- Assures that direct reports are properly licensed in the jurisdictions serviced.
- Ensures claims files are coded correctly and adequate documentation is made by claims examiners.
- Performs other duties as assigned.
- Supports the organization's quality program(s).
SUPERVISORY RESPONSIBILITIES
- Administers company personnel policies in all areas and follows company staffing standards and training recommendations.
- Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.
- Provides support, guidance, leadership and motivation to promote maximum performance.
QUALIFICATIONS
Education & Licensing: Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certifications as applicable to line of business preferred.
Experience: Six (6) years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.
Skills & knowledge: thorough knowledge of claims management processes and procedures for multiple product lines, excellent oral and written communication, including presentation skills, PC literate, including Microsoft Office products, leadership/management skills, analytical and interpretive skills, ability to work in a team environment, and the ability to meet or exceed Performance Competencies
Work environment requirements include –
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.
Originally posted on Himalayas