Description

JOB DESCRIPTION

ESIS ProClaim is seeking an experienced Senior Claims Manager to lead a team of claims professionals handling complex general liability and professional liability claims, including New York Labor Law claims.

Location: NYC (NY), Jersey City (NJ), or Simsbury (CT)

Key Objective:
Reporting to the AVP and VP of Claims, the Claims Team Leader will support, guide, and develop team members in all aspects of third-party claims management. This includes assigning new claims, evaluating coverage, investigating facts, securing evidence, addressing subrogation and recovery, apportioning liability, and settling claims in alignment with best practices and client instructions.

Responsibilities:

• Supervise a team of claims professionals.
• Assign new claims and provide direction on policy coverage, investigation, and determination of policy obligations.
• Maintain a diary system to ensure each file is reviewed at least every 90 days.
• Provide coaching and feedback to direct reports.
• Develop, monitor, and share performance and productivity goals.
• Review and analyze performance results, productivity, and audit/quality review outcomes.
• Guide claims professionals in collaborating effectively with defense counsel and litigation teams, as directed by clients.
• Ensure preparation of detailed 90-day Claim Summary Reports and provide client updates on investigations, settlement opportunities, claim denials, reservations of rights, third-party tenders, and recommendations for claims review meetings.
• Post loss and expense reserves within authority limits and recommend reserve changes above authority to AVP and/or VP of Claims.
• Review claim progress and status with claims leadership, discussing issues, opportunities, and remedial actions.
• Prepare and submit reports on unusual or potentially undesirable exposures, such as allegations of bad faith or unfair claim practices.
• Assist claims leadership in improving claims handling procedures.
• Collaborate with Partnership Leaders to deliver results, attend meetings, and participate in claim reviews.
• Verify that claims professionals have secured appropriate releases, proofs of loss, or compensation agreements, and issue company drafts for claim payments.
• Maintain accurate and complete claim files, including notes, reports, photos, and documentation.
• Adhere to all company and regulatory compliance requirements.
• Update claims promptly with Medicare data and address Medicare reporting and interest.
• Meet or exceed established performance goals.

Requisition #: 29342

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