Claims representative jobs in Port Orange, FL

DETAILS Claims Supervisor III - Property & Casualty Department: Property & Casualty Reports To: Claims Manager Property & Casualty FLSA Status: Exempt Job Grade: 16 ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today! POSITION SUMMARY Athens Administrators has an immediate need for a full-time Claims Supervisor III to support our Property & Casualty department. Management that lives less than 36 miles from our local office AND have a direct report in the office, are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee lives in a state we operate in (includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA and WV). Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. Employees work a 37.5-hour work week. Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines. The Claims Supervisor is responsible for supervising, directing, and coordinating the activities of a team handling complex liability claims within assigned authority limits and consistent with good faith handling practices. These claims are typically mid to high exposure. The goal of the position is to ensure the delivery of quality service to customers while protecting their interests. PRIMARY RESPONSIBILITIES Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned: Responsible for handling a unit of senior and complex examiners handling claims of a severe and complex nature involving bodily injury, property damage, occurrence or claims made and complex coverage. Exposures are typically valued at levels of 100K or higher Able to handle multiple coverage lines with specific concentration on high exposure Auto, GL, PL (E&O) involving varying program segments Plans, schedules, and supervises the work activities of the unit's personnel in reviewing, analyzing, investigating, negotiating, and settling claims in compliance with established standards and expectations Reviews claim loss reports, assesses complexity of submitted claims and assures claims are assigned to appropriate personnel (based on licensure, knowledge, skills, and abilities) to ensure optimal claims handling within team; serves as a technical resource for staff as necessary Reviews and approves, within assigned authority limits, claim expenses and settlements that exceed the claim adjusters granted authority; appropriately refers claim expenses and settlements that exceed personal authority limits for approval Oversight of complex and reportable litigation and coverage cases. Serves as the primary liaison between the examiners and clients on case conferences and referrals Must be able to interpret coverage, provide guidance on coverage matters and review reservation of rights and disclaimers for carrier approval Monitors and evaluates reserves for claims within the unit to ensure that they are adequate and that reserve adjustments are made, when necessary, consistent with established time frames Conducts regular reviews of pending and closed files to determine whether claims are handled appropriately; identifies areas for improvement and discusses individual training and development needs as necessary Prepares monthly reports on quality control, pending and closed file reviews and reserve activity to track and communicate unit performance relating to production, opportunity areas and significant achievements Maintains awareness of existing and proposed legislation, court decisions and emerging trends in claims litigation to monitor the company's compliance with the Unfair Claims Practices Act and to recommend process and/or procedure changes Participate in special projects such as analyzing reserves, leakage, methods for pending reduction and acquisition candidates Review and approve direct report monthly expense reports and related operating expenses for their assigned unit. Works closely with all levels of management to ensure compliance with budget targets for compensation, expense control and profitability. Assists in the selection of and monitors the performance of external vendors Works closely with the claims management team to identify needs of the unit and assist with hiring, training, motivating, and retaining staff, evaluating staff performance, encouraging staff development, recommending salary actions, and, as necessary, developing performance improvement plans and recommending individual terminations of employment Works with Management to achieve company initiatives and performance goals Works with clients to address issues regarding policies, and procedures to fulfill the service requirements of the account. Reviews and evaluates performance of staff in accordance with company performance guidelines Resolves employee/workflow problems Leads staff unit meetings Attends client and company meetings, as required, either in-person or remotely Conducts claim reviews with clients and other stakeholders Assures consistent and accurate claims coding throughout the unit ACCOUNTABILITIES Supervisory Responsibilities Supervising, scheduling, assigning, monitoring, and evaluating work of assigned staff are responsibilities for supervisor positions. Provide direct supervision to examiners, adjusters, claims assistants and all liability claims staff Review and approve direct report's monthly expense reports ESSENTIAL POSITION REQUIREMENTS The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations. High School Diploma or equivalent (GED) required for all positions AA/AS or BA/BS preferred but not required Possesses a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX, or FL preferred Additional State Adjuster License(s), may be required within 180 days Maintain licenses and continuing education requirements in all states. 8+ years' experience in a claims lead or supervisor position required High exposure Auto, GL and Professional Liability claims experience Relies on extensive experience and judgment to plan and accomplish goals with a minimum 8-10 years' complex/major claims experience including proficiency in investigation and resolution of mid to severe to major casualty claims In-depth understanding of company operating structure Thorough knowledge of claims procedures, litigation management, client reporting requirements and Multi-line coverage exposures Proficiency in determining case value, negotiating settlements, and understanding CA jurisdictional statutes and regulatory requirements that drive exposure Comprehensive knowledge of claims handling systems Maintain confidentiality of information Thorough knowledge in coverage and claims investigation techniques. People management skills including interviewing skills, training, team building, and performance management. Proficiency at applying business and technical acumen by understanding how the business works and how technology supports business initiatives. Leverages technology for self and staff to improve efficiency. Handles stressful situations and deadline pressures well Thinks strategically and creatively about business (pricing, products, and outcomes) Partnering with team to ensure on time task completion; done through delegation and leading by example, executing tasks rather than just instructing to execute tasks Embrace the leadership role and can be counted on to help senior management drive towards the desired results and to exceed goals successfully. Command of company and department policies, practices and procedures including supervision, training, and performance evaluation. Able to track claims activity and properly document all actions Advanced verbal, interpersonal and written communication skills Skilled at presenting in small and large group settings unique to self-insured districts. Effectively influence people to achieve unit and organizational objectives Skilled at developing and maintaining effective relationships with others (co-workers, customers, vendors, management, and other key stakeholders) to achieve organizational goals Mathematical calculating skills Exercise independent judgment and analytic ability in solving complex and sensitive problems Computer processing skills, including the ability to leverage technology for self and staff to improve efficiency Ability to type quickly, accurately and for prolonged periods Proficient in Microsoft Office Suite Ability to learn additional computer programs Able to plan, prioritize and organize claims workload for a unit Ability to work independently and in a group setting Strong attention to detail and the ability to research and resolve problems Advanced organizational skills to meet multiple deadlines and to plan and effectuate short- and long-range Company and department objectives. Must be flexible, adaptable, and positive. Exhibit passion and energy for ensuring that all employees are respected and treated in a manner consistent with Athens Values. Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization Seeks to include innovative strategies and methods to provide a high level of commitment to service and results Ability to be demonstrate care and concern for fellow team members and clients in a professional and friendly manner Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor Athens' operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company. Must be able to reliably commute to meetings and events as required by this position Availability for extended and long distance, overnight travel, when required APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at *********************************************** Feel free to include a cover letter if you'd like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: ************************************************************************************************** This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training. Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development. THANK YOU! We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don't forget to check out our website at ******************* as well as our LinkedIn, Glassdoor, and Facebook pages! Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://*******************/careers/why-work-here