About this role
Manage daily operations of a Field Property claims service handling team for the NY/NJ territory in a remote role. Oversee investigations and employee performance, prevent fraud, manage reserve/settlements, and direct litigated claims in collaboration with legal teams.
Key Responsibilities
- Oversee day-to-day claims service handling and investigations
- Monitor employee performance using spot checks and data tools like Power BI
- Implement continuous improvement and fraud detection/prevention protocols
- Approve reserves, settlements, and review settlement proposals
- Manage litigated claims and collaborate with legal teams on case handling
Technical Overview
Uses claims operational performance monitoring and analytics through tools including Power BI and flight decks, with emphasis on trend analysis. Applies legal knowledge such as comparative negligence laws across all 50 states to guide investigations and claim handling decisions.
Ideal Candidate
The ideal candidate is a claims operations leader with experience managing a claims service handling team for Field Property Claims in the NY/NJ territory. They are skilled in claims investigation oversight, performance management using tools like Power BI, fraud detection protocols, and managing reserve/settlement and litigated claims in coordination with legal teams.
Must-Have Skills
Oversees the day-to-day operations of a claims service handling team including the investigation and evaluation of claimsMonitor and assess employee performance through spot checks (phone listeningfile reviews) and data tools (Power BIflight deckstrend analysis)Develop and implement continuous improvement initiativesCreate and enforce protocols to detect and prevent fraudulent claims; review claims with potential fraudApply technical knowledge (comparative negligence laws across all 50 states)Evaluate and approve reserve and settlements outside of individual authoritiesOverseemanageand direct litigated claims; mentor others on approachCollaborate with legal teams to ensure proper handling of litigation casesMonitor and report on litigation outcomes to identify trends and areas for improvement
Tools & Platforms
Power BIflight decks
Required Skills
Claims service handlingClaims investigationClaims evaluationPerformance managementSpot checksPhone listeningFile reviewsPower BIFlight decksTrend analysisContinuous improvement initiativesFraud detectionFraud preventionComparative negligence laws across all 50 statesCustomer serviceEscalated complaints resolutionReserve and settlements approvalSettlement proposals reviewCost controlContractual indemnificationLitigated claims managementLegal team collaborationLitigation outcomes reportingClaims data analysis
Hard Skills
Claims service handlingClaims investigationClaims evaluationPerformance managementSpot checksPhone listeningFile reviewsData toolsPower BIFlight decksTrend analysisContinuous improvement initiativesFraud detectionFraud preventionComparative negligence laws across all 50 statesCustomer serviceEscalated complaint resolutionReserve and settlements approvalSettlement proposals reviewCost control related to claim handling activitiesContractual indemnificationLitigated claims managementLitigation case collaboration with legal teamsLitigation outcomes reportingClaims data analysisReserve and settlement decision-making
Soft Skills
LeadershipMentorshipCommunicationDecision-makingRelationship buildingCustomer service orientationDispute resolutionEmployee coachingOperational excellence
Keywords for Your Resume
Mgr Service ClaimsManager Service ClaimsUnit ManagerField Property ClaimsNY/NJ territoryremote Full-time/Exemptclaims service handling teaminvestigation and evaluation of claimsperformance managementspot checksphone listeningfile reviewsPower BIflight deckstrend analysiscontinuous improvement initiativesfraud detectionfraud preventioncomparative negligence laws across all 50 statescustomer serviceescalated complaintsreserve and settlementssettlement proposalscost controlcontractual indemnificationlitigated claimslegal teamslitigation outcomesclaims datasettlements outside of individual authoritiesclaims investigationcomparative negligence laws
Deal Breakers
Must be able to oversee and manage a claims service handling team including investigation and evaluation of claims, Must be able to evaluate and approve reserve and settlements outside of individual authorities, Must be able to oversee litigated claims and collaborate with legal teams
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