Claims Manager - TPA Workers Comp

XL CATLIN; Exton (Chester County); On-site; USD 130,000 - 228,000; Full time

Job summary

An established industry player is seeking a dedicated Claims Leader to oversee complex Workers’ Compensation claims. In this pivotal role, you will guide a team of specialists, ensuring compliance and delivering exceptional service to clients. Your expertise in investigation, negotiation, and leadership will drive continuous improvement and foster collaboration across departments. Join a company committed to diversity and sustainability, where your contributions will shape the future of claims management in a dynamic environment. If you’re passionate about making a difference and leading teams to success, this opportunity is perfect for you.

Benefits

Health Benefits

Wellness Programs

Flexible Working Arrangements

Family-Friendly Benefits

Sustainability Initiatives

Qualifications

• Advanced skills in investigation, evaluation, negotiation, and resolution of high-value claims.
• Expertise in analyzing and resolving coverage and compliance issues.

Responsibilities

• Lead Claim Specialists in managing high-value Workers’ Compensation claims.
• Ensure excellent customer service standards are upheld by TPAs.

Skills

Investigation Skills

Negotiation Skills

Claims Resolution

Leadership Skills

Communication Skills

Organizational Skills

Strategic Thinking

Collaboration Skills

Job description

Job Number:

25AACL09D20241209

DISCOVER your opportunity

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?

1. Line leadership of Claim Specialists directing high-value Workers’ Compensation claims handled by third-party administrators (“TPAs”) filed throughout the United States for our US Risk Management, Construction, Mid-Market, Programs, and other underwriting teams.
2. Approval of coverage letters or coordination of complex coverage referrals to Claim Legal and outside coverage counsel.
3. Resolution of compliance-related issues with TPAs, Claim Management, and our Compliance Department.
4. Direction of TPAs in accordance with AXA XL best practices in the major phases of claim handling including coverage, investigation, evaluation, reserving, recovery, and resolution. Evaluation and provision of reserve and settlement authority within AXA XL parameters.
5. Delivery of excellent customer service to policyholders and brokers, ensuring the same high customer service standards are upheld internally and by TPAs.

Additional responsibilities include:

• Collaboration with internal claim resources such as regional practice leaders and Claim Legal to ensure optimal outcomes and mitigation of claim expense.
• Coordination with Claim Account Management to communicate claim issues and results, support the TPA audit process, and collaborate on technical and service issues relating to TPA performance.
• Presentation of claim results, trend information, and lessons learned to stakeholders.
• Recommendation of additional metrics to support team and departmental goals.

You will report directly to the Head of Primary Casualty Claims.

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

Required Skills and Abilities:

• Advanced skills in investigation, evaluation, negotiation, and resolution of high-value/complex Workers’ Compensation Claims.
• Expertise in identifying, analyzing, and resolving coverage and compliance issues.
• Multi-jurisdictional (U.S.) experience.
• Significant experience managing claims in an unbundled insurance model.
• Leadership skills, including influencing internal and external relationships, coaching, setting expectations, evaluating, and accountability.
• Excellent verbal and written communication skills.
• Advanced organizational and time management skills.
• Strategic thinking and ownership of continuous process improvements.
• Strong teamwork and collaboration skills.

FIND your future

AXA XL, the P&C and specialty risk division of AXA, is known for solving complex risks. We provide re/insurance solutions for mid-sized companies, multinationals, and individuals, combining a comprehensive capital platform, data-driven insights, leading technology, and top talent in an inclusive, agile workspace.

We are committed to diversity and inclusion, offering resources like Business Resource Groups, flexible working arrangements, family-friendly benefits, and sustainability initiatives.

Our 2023-26 Sustainability strategy, “Roots of resilience,” focuses on protecting ecosystems, addressing climate change, and embedding sustainable practices.

The U.S. pay range for this position is $130,000-$227,500 USD, with actual pay based on skills, experience, and location. We offer competitive benefits, including health, wellness, and development programs.

Location

US-PA-Exton

Other Locations

US-CT-Hartford

Job Field

Claims

Schedule

Full-time

Job Type

Standard

AXA XL is an Equal Opportunity Employer and does not discriminate based on protected characteristics.