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Responsibilities will include reviewing workers' compensation, auto, liability and property claim files to determine if subrogation from any source is feasible. You will manage assigned claims with a value up to $50K, document and maintain claim files, pursue subrogation from adverse parties and negotiate settlements; strong knowledge of insurance/subrogation concepts, practices, procedures and techniques as well as negotiation, analytical and organizational skills required. Additionally, duties consist of developing a national subrogation network for frequency driven claims and inter-acting with various claim groups.
Basic Function and Scope:
Directly responsible for all operations and personnel issues in the claim department. Through file audits, employee appraisals or other avenues, monitors conformance of staff to company and industry standards, procedures and objectives.
- Responsible for providing day to day administrative and technical supervision and guidance to entire claims staff. Identifies and establishes workload standards.
- Develops procedures and policies to enhance and improve the processing, investigation, and settlement of claims. Reviews and approves settlements of complex and high dollar claims.
- Coordinates the administration of the quality control program to monitor and control department activities, and implements corrective actions as needed.
- Approves special handling procedures for specified accounts. Monitors staff for compliance with all statutory regulations, Unfair Claim Practices acts, Best Practices, and special handling instructions.
- Makes budget forecasts, performance reviews, and salary recommendations. Responsible for oversight of all staffing, training, and mentoring. Effectively communicates with all internal and external customers including corporate as required. Resolves personnel related problems within the department.
- For claims in litigation, tracks all scheduled trials, conducts department meetings for discussion of cases scheduled for trial, and decides which claims should proceed to trial. Maintains list of approved panel counsel attorneys and agreed rates. Directly handles those claims in litigation involving coverage disputes in which Berkley Entertainment or another Berkley company is a party.
- Reviews and approves all reservations of rights and denials of coverage for claims. Advises underwriting staff regarding coverage issues, and policy and endorsement form language.
- Directly supervises and mentors AVP’s and maintains a supervisor diary on their files.
- Responds to inquiries from regulatory agencies, and ensures department is in SOX compliance.
- Supports Company’s marketing efforts through account and broker visitations, timely service, designing of action plans to correct deficiencies and participates in presentations as required.
- Participates as an accountable member of the Management team and promotes company strategies and values.
The position is responsible for assisting with all aspects of the accounts payable closing cycle and preparation of various components of the company’s expense reporting packages based on US GAAP and Statutory requirements. Reporting and accounting responsibilities include payments, accruals, vendor management, expense analysis, and reporting of expenses on a monthly and annual basis.
- Responsible for full accounts payable (P2P - Procure to Pay) cycle for the supported operating units.
- Primary liaison with BFINS (centralized payment team) for all aspects of expenses – payment, coding, research, approval (automated and manual), accruals, analysis, etc.
- Responsible for expense accounting, reporting, and analysis leveraging Egencia, Perceptive, CCER, Hyperion Essbase, PeopleSoft and other company used systems.
- Provide analysis with the selection of new vendors and evaluation of existing vendors in a procurement role.
- Assist with the preparation and analysis of supporting schedules for expense journal entries in a controlled and timely manner.
- Other duties as assigned.
This position participates in development and support of data through incremental development of the Data Warehouse and then presentation to the business community through query results and/or reporting structures. This role includes defining, coding and maintaining the extraction, transformation and load of data to and from the data warehouse in conjunction with many independent data marts. This role participates throughout the project life cycle from planning to production implementation.
- Designs, develops, writes, modifies and implements software programming applications
- Convert data from various file formats to relational database (ETL)
- Experience with SSRS and T-SQL
- Create reports and/or electronic files as requested
- Participates in testing through test definition, review and validation
- Performs a variety of intermediate tasks
- Seeks input from manager and team members to apply experience and judgment towards accomplishing assignments
- Work with technical resources (internal and external) to ensure accurate translation of specifications into workable application code
- Work with business users on a day-to-day basis
- Perform all other duties as assigned
Under limited supervision, reviews, evaluates, negotiates and processes WC Claims of serious to significant complexity, makes recommendations for resolution, and litigation management as appropriate. Has contact with agents, policy holders, defense and applicant attorneys. This position will be working in the Sports Division of the Claims Department. The position is located in either our Irving, TX office or California, depending on residence of the employee.
- Responsible for the day to day management of serious to complex workers compensation claims.
- Conduct initial investigation to confirm coverage is in place for the loss and that the loss itself is compensable per California specific requirements, make quality, prompt contacts with employer, claimant, doctor and any witnesses, document and confirm initial diagnosis and prognosis.
- Ensure that the claim is adequately reserved, review and pay medical bills and expense bills timely and accurately, recognize and evaluate each case for subrogation potential, recognize potential fraud cases, document return to work and light duty efforts, accurately calculate, code and issue indemnity payments, promptly and accurately complete required internal Large Loss reports.
- Proactively manage all litigated claims by clearly documenting the litigation plan and budget, retaining competent counsel, communicating with counsel on a regular basis and clearly documenting the litigation action plan and strategy.
- Participate in claim reviews, which may require some travel.