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- Responsible for managing policy functions and the timely issuance of new business and renewal policies, cancellations, and endorsements.
- Maintain department workflows and procedural issues to manage the effective flow of business (new and renewal) through the company while upholding service standards.
- Create and maintain policies and procedures associated with above responsibilities.
- Identify and communicate trends, resolve issues and implementing process improvements.
- Present information and respond to questions from employees, co-workers and management.
- Establish SLA’s and staffing levels to meet business requirements.
- Responsible for overseeing policy related system enhancements and procedures, including new system implementations.
- Delegate and monitor work assignments, set expectations, inspire and motivate others to perform well and accept feedback from others.
- Management of team (hiring, establishing goals and objectives for team members, performance management, etc.) and associated Human Resources functions.
- Responsible for supervising the team that handles new and existing accounts via the call center.
- Responsible for employee development including but not limited to systems, procedural, customer service and general working knowledge of insurance.
- Provide regular performance feedback; complete written performance reviews.
- Act as a liason and work with various departments within the organization on resolving policy issues.
- Direct relationships with other departments to resolve issues and develop standards of doing business.
- Work with other departments in order to collect data, map critical processes and participate in forming recommendations for improvements in work product and services.
- Embrace a culture of Innovation by exhibiting Key Risk’s Innovation Behaviors, and by actively participating in idea submission, experimentation and implementation.
- Professional Development – Develop job skills through Company training and the pursuit of industry designations
- Professional Relationships – Develop and maintain strong working relationships with all stakeholders, including insureds, agency partners, NCCI/State Bureau personnel and Key Risk/WRB associates (underwriters, Regional Vice Presidents, auditors, information technology, claims and other WRB companies)
- Client Service Infusion – support CSI program by promoting and upholding 4 key behaviors
- Innovation – embrace and demonstrate Innovative behaviors
Key Risk is looking for a Director of Litigation, Counsel
- Keep abreast of all arising workers compensation case law, rules and regulations for our core jurisdictions
- Inform claims organization of case law which impact claims handling or has educational value. Provide synopsis, the case link and how it affects claims department policy and procedures.
- Review claims to ensure appropriate referrals to approved defense counsel.
- Schedule and attend stewardship meetings with defense counsel.
- Manage Defense Council and conduct litigation reviews
- Maintain Defense Counsel Guidelines.
- Assist in the development of a counsel referral method that promotes effective outcomes and minimizes or controls litigation costs.
- Maintain legal contracts.
- Establish and maintain effective working relationships with claims staff, supervisors, providers, and other departments of Key Risk.
- Develop training materials for litigations specialists and claim professionals
Key Risk is looking for an enthusiastic individual who wants to learn account management and technical knowledge of workers compensation claims.
- Interface with Underwriting, Risk Management, and clients in controlling costs and loss ratios
- Conduct investigation of workers' compensation claims assigned
- Handle all technical aspects of claims, including coverage, disability benefit management, medical management, litigation management, file management, subrogation, reserving and settlement
- Maintain and demonstrate knowledge of the Workers' Compensation Act and Rules and Regulations in jurisdictions assigned
- Immediately notify management of large exposures and comply with reinsurance reporting requirement
- Monitor expenses and effectiveness of inside/outside vendors
- Assume full responsibility for all phases of account management for accounts as assigned and inform management of any unfavorable trends
- Actively work with mentor in monitoring loss ratio for accounts assigned
- Participate in client meetings for training on claims issues and assist with claims service meetings for new accounts as requested
Key Risk is looking for an enthusiastic professional who will be responsible for the management of medical only workers’ compensation claims.
- Maintain good lines of communication with employers, adjusters, and providers
- Discuss with an employer, issues relative to an injured workers’ return to work status
- Request medical notes, proper billing format, and other written/verbal information from employers and medical providers to determine appropriateness of payment of medical bills and whether a claim is truly medical only
- Timely and accurately reserve for medical only claims assigned
- Document relevant written and oral communication received relative to medical-only claims in the log notes
- Discuss with an employee, issues relative to whether a bill has been paid or whether travel or medical reimbursement has been issued
- Assist in the management of communication of the unit with customers, providers and injured employees
- Enter medical notes into claim log as required
- Index images as needed
- Identify potential subrogation claims and notify appropriate supervisor