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Develop and implement quality and compliance standards.
Partner with the Claims Analyst to develop internal quality and compliance reporting.
Complete monthly audits for internal and external claims handling
Present findings to leadership and Claims Team.
Partner with the Claims Manager to develop and implement training to the claim staff.
Review and report on third party administrator performance with regards to quality and
Structure and organize compliance related matters such as letter compliance, timing
requirements by state, and review of DOI market conduct exams.
Lead the planning, implementation and execution of claims compliance projects from
initiation to completion.
Ensure claim department assigned projects results meet desired outcomes regarding
timeliness and quality.
Coordinate with the Claims Team and other functional departments in the development
of new products, coverages and forms.
Recognize and train staff on any regulatory and claim compliance updates.
Perform other job-related duties requiring the same general knowledge, skills and
degree of responsibility.
Technical expertise in claim processes, procedures and laws as well as a thorough
understanding of the assigned specific claim line (i.e., Commercial General Liability,
Workers' Compensation, Property, Commercial Auto).
Eight plus years in claim handling, auditing, and/or management of claim personnel.
Knowledge of property and casualty estimating tools.
Bachelor’s Degree required.
Insurance coursework (i.e., CPCU, IIA) preferred.
Candidates must have and maintain, or be able to promptly obtain a Texas Independent