Senior Claims Specialist - TPA Liability

Senior Claims Specialist – TPA Liability

Walnut Creek, CA /Los Angeles, CA I USA

Our Claims team sets us apart. Our experienced Claims professionals use their specialized expertise to handle even the most complex claims seamlessly. How do you make a good thing better? You focus on excellence and creating a culture of continuous improvement. You create an environment that fosters collaboration, customer service and colleague development. You build a team of passionate and innovative claims experts who see success as a reason to roll up their sleeves and drive for improvement.

DISCOVER your opportunity

What will your essential responsibilities include?

• Active management of caseload of high-value liability claims venue throughout the United States for assigned clients in our US Risk Management, Construction, Programs and other supported business units.
• Effectively coordinate coverage referrals and compliance related issues with Third Party Administrators (TPAs), Claim Management and our Compliance Department.
• Conduct claim handling and oversight of TPAs in accordance with AXA XL best practices in the major phases of claim handling including coverage, investigation, evaluation, reserving, recovery, and resolution.
• Provide oversight, guidance and direction to TPA claim adjusters on all major phases of claim handling including coverage, investigation, evaluation/reserving, recovery, and resolution.
• Collaborate with business partners, as appropriate, on claim management and strategy to help deliver the most optimal outcome and ensure, to the extent possible, that we are in alignment on our evaluation of the exposure and strategy to resolve.
• Collaborate and consult with internal claim resources such as regional practice leaders and claim legal to ensure the most optimal outcome and mitigate claim expense.
• Perform Claim Account Management for assigned clients to communicate claim issues and results, participate in the TPA audit process, and collaborate on technical and service issues relating to the TPA performance and the client.
• Collaborate proactively with internal and external stakeholders regarding claim experience, results, and trends ( actuarial, reinsurance, credit risk and underwriting).
• Provide input into the development of key metrics to support Claim Audits and assist in the coordination and retention of external counsel, as needed.

You will report to the Claims Manager – TPA Liability.

SHARE your talent

We’re looking for someone who has these abilities and skills:

Required Skills and Abilities:

• Advanced claim handling experience involving high value/complex claim management and litigation management.
• Defined expertise in managing coverage and compliance related issues.
• Multi-jurisdictional ( experience.
• Demonstrated expertise in designated line(s) of business: Automobile, Construction, and General Liability.
• Experience managing claims in an unbundled insurance model.
• Experience with NY Labor Law desired.
• Overall knowledge of worker’s compensation, employers' liability desired, but not required
• Leadership: Demonstrates managerial courage and ability to influence actions of external relationships. Coaches, sets expectations, evaluates and holds people accountable for delivering.
• Effective communication and negotiation skills: Excellent verbal and written communication, and negotiation skills.
• Effective organizational and time management skills.
• Strategic thinking: Exhibit ownership to look for ways to continuously improve internal processes as it relates to improving claim outcomes and managing the performance of external relationships.
• Effective teamwork/collaboration skills in order to effectively collaborative with Regional Practice Leads, Claim Legal, TPA and clients to produce desired outcomes, as well as with other internal and external stakeholders such as, brokers, actuarial, reinsurance and business partners to communicate regarding claim results, experience and trends.

FIND your future

AXA XL, the P&C and specialty risk division of AXA, is known for solving complex risks. For mid-sized companies, multinationals and even some inspirational individuals we don’t just provide re/insurance, we reinvent it.

How? By combining a comprehensive and efficient capital platform, data-driven insights, leading technology, and the best talent in an agile and inclusive workspace, empowered to deliver top client service across all our lines of business − property, casualty, professional, financial lines and specialty.

With an innovative and flexible approach to risk solutions, we partner with those who move the world forward.

Inclusion & Diversity