Keolis America, Inc
Senior Director of Claims
Keolis America, Inc, Boston, Massachusetts, us, 02298
Location:
Boston
Skills
Process Design / Management and Reporting
Strong Customer Service skills and ability to influence others
Ability to engage cross functionally in support of strategic business goals
Effective communication with multiple levels of the organization including executive leadership as well as with vendors / claimants as needed.
Sound decision making skills having practical sense of escalation needs
Effective leadership skills with ability to motivate team members / vendors / peers
Detail oriented with solid ability to apply analytics to decision making and KPI development
Knowledge and Experience
Experience designing and leading claims management programs
Experience in partnering with Legal, TPA and Insurers for effective claims litigation management
Financial acumen in liaising on actuarial studies and accrual management
Demonstrated knowledge of best practices in claims management
Experience developing educational materials to communicate / educate program stakeholders
Knowledge of RMIS systems
Proficiency in Microsoft Office Programs - Word, PowerPoint, Excel
7+ years of Insurance and Claim Management
Education
Bachelor’s Degree
Professional Certifications / Designations such as CIC, ARM, CRMP, CPCU preferred.
Key Accountability
Claims Process Management
Work with location and TPA to ensure effective processes of preservation / collection of all pertinent documentation including videos, recordings, etc. for investigations
Partner with TPA to evaluate and develop strategies for prompt resolution
Collaborate with In-House Legal with respect to litigated claims and settlement activity
Seek and maintain best practice claim management processes (e.g., prompt claimant contact, expression of empathy; resolution strategy development; prompt resolution)
Interact routinely with internal and external customers
Oversee the development of monthly claims reports in partnership with TPA and or financial analyst. Present to various audiences including CEO.
Meet monthly with TPA for program status, needs, trends, action plan updates
Collaborate extensively with stakeholders related to safety, risk mitigation, and claim reduction
Review claim reports and determine defense/development and provide feedback to TPA to develop strategy for resolution taking accident/event severity; known facts and venue
Review reserve needs with TPA for appropriateness, presenting changes to the Reserve Committee with justification ensuring approvals in line with delegation of authority.
Identify cases to litigate and engage In-House Litigation Attorney on strategy
Attend settlement conferences and mediation when necessary
Conduct routine claim reviews with business leaders, adjusters, safety, finance, and leadership
Conduct post review of all significant resolutions to identify strengths and areas for improvement in the claim management process
Insurance Program Management
Lead insurance renewal strategy and analysis discussions
Oversee development of renewal submissions
Innovation Projects
Work with external partners, i.e., panel counsel; insurance consultant; vendors as well as internal partners to identify and evaluate process flows, tools etc. to enhance program
Utilize Insurance Broker resources to provide 3rd party audits with development of action plans for improvement based on audit results
Utilize TPA audit findings to develop process improvement strategies and action plans
Support business development team in modeling insurance and claims projections for bidding opportunities and participate in RFP efforts
Additional Statements
Drug and alcohol screening:
Employment contingent upon passing pre-employment drug and alcohol screen. Also, contingent upon receiving a favorable background check. Must pass a physical examination.
Safety commitment:
Safety is a way of life at Keolis. By placing safety first, we ensure the wellbeing of our employees, customers, and communities.
Environmental commitment:
Keolis is committed to protecting the environment by minimizing the impact of operations to our people and the communities in which we operate.
EEO statement:
Our policy is to afford Equal Employment Opportunity to qualified individuals regardless of their race, color, sex, religion, age, creed, marital status, national origin, ancestry, physical or mental disability, sexual orientation, or gender identification.
#J-18808-Ljbffr
Boston
Skills
Process Design / Management and Reporting
Strong Customer Service skills and ability to influence others
Ability to engage cross functionally in support of strategic business goals
Effective communication with multiple levels of the organization including executive leadership as well as with vendors / claimants as needed.
Sound decision making skills having practical sense of escalation needs
Effective leadership skills with ability to motivate team members / vendors / peers
Detail oriented with solid ability to apply analytics to decision making and KPI development
Knowledge and Experience
Experience designing and leading claims management programs
Experience in partnering with Legal, TPA and Insurers for effective claims litigation management
Financial acumen in liaising on actuarial studies and accrual management
Demonstrated knowledge of best practices in claims management
Experience developing educational materials to communicate / educate program stakeholders
Knowledge of RMIS systems
Proficiency in Microsoft Office Programs - Word, PowerPoint, Excel
7+ years of Insurance and Claim Management
Education
Bachelor’s Degree
Professional Certifications / Designations such as CIC, ARM, CRMP, CPCU preferred.
Key Accountability
Claims Process Management
Work with location and TPA to ensure effective processes of preservation / collection of all pertinent documentation including videos, recordings, etc. for investigations
Partner with TPA to evaluate and develop strategies for prompt resolution
Collaborate with In-House Legal with respect to litigated claims and settlement activity
Seek and maintain best practice claim management processes (e.g., prompt claimant contact, expression of empathy; resolution strategy development; prompt resolution)
Interact routinely with internal and external customers
Oversee the development of monthly claims reports in partnership with TPA and or financial analyst. Present to various audiences including CEO.
Meet monthly with TPA for program status, needs, trends, action plan updates
Collaborate extensively with stakeholders related to safety, risk mitigation, and claim reduction
Review claim reports and determine defense/development and provide feedback to TPA to develop strategy for resolution taking accident/event severity; known facts and venue
Review reserve needs with TPA for appropriateness, presenting changes to the Reserve Committee with justification ensuring approvals in line with delegation of authority.
Identify cases to litigate and engage In-House Litigation Attorney on strategy
Attend settlement conferences and mediation when necessary
Conduct routine claim reviews with business leaders, adjusters, safety, finance, and leadership
Conduct post review of all significant resolutions to identify strengths and areas for improvement in the claim management process
Insurance Program Management
Lead insurance renewal strategy and analysis discussions
Oversee development of renewal submissions
Innovation Projects
Work with external partners, i.e., panel counsel; insurance consultant; vendors as well as internal partners to identify and evaluate process flows, tools etc. to enhance program
Utilize Insurance Broker resources to provide 3rd party audits with development of action plans for improvement based on audit results
Utilize TPA audit findings to develop process improvement strategies and action plans
Support business development team in modeling insurance and claims projections for bidding opportunities and participate in RFP efforts
Additional Statements
Drug and alcohol screening:
Employment contingent upon passing pre-employment drug and alcohol screen. Also, contingent upon receiving a favorable background check. Must pass a physical examination.
Safety commitment:
Safety is a way of life at Keolis. By placing safety first, we ensure the wellbeing of our employees, customers, and communities.
Environmental commitment:
Keolis is committed to protecting the environment by minimizing the impact of operations to our people and the communities in which we operate.
EEO statement:
Our policy is to afford Equal Employment Opportunity to qualified individuals regardless of their race, color, sex, religion, age, creed, marital status, national origin, ancestry, physical or mental disability, sexual orientation, or gender identification.
#J-18808-Ljbffr