Claims Manager

Hallcon provides mission critical, employee transportation services to the largest railroad operators in North America. The Insurance and Claims Manager oversees the day-to-day activities associated with insurance programs and claims management. This includes oversight of external program providers including but not limited to:  insurance brokers, third-party claims administrators; defense counsel, legal bill audit.

Key Role and Responsibilities

• Oversee the day-to-day activities of external program providers including but not limited to: insurance brokers, third-party claims administrators; defense counsel, legal bill audit services, and experts
• Utilizes data to analyze workers’ compensation and auto liability claim costs, trends and cost savings resulting from claim management processes and services. Designs or modifies cost management initiatives in response to data results
• Responsible for day-to-day management of insurance programs and annual renewal process across all lines of insurance
• Providing management oversight to Third Party Administrators workers’ compensation claims personnel by monitoring the claims online using the Third Party Administrators claim systems
• Reviewing monthly loss run trends, reportable claims and /or problematic claims
• Participate in claim file reviews with insured’s, brokers and Third Party Administrator’s claim personnel
• Participate in audits of Third Party Administrators claim offices
• Interface with underwriting on claim status, exposures and other factors impacting their risks
• Review and approve Third Party Administrator’s monthly claim handling fees
• Manage return-to-work program per organizational policies and federal & state laws; approve all return to work restrictions
• Serve as single point of contact, coordinating with TPA, insurance carriers, claimants, defense counsel and internal stakeholders

• Ensure workers’ compensation and auto liability claims are thoroughly investigated by the Hallcon field personnel and third-party administrator, following claim management best practices

• Manage return-to-work program per organizational policies and federal & state laws; approve all return to work restrictions
• Conduct quarterly reviews on large claims with broker and TPA 
• Review and approve reserve recommendations within established authority
• Authorize defense counsel assignments, approve and coordinate surveillance, approve Medical Case Management assignments
• Work with adjusters and attorneys on claim resolution strategies and settlement agreements 
• Work closely with the finance team to track insurance claim receivables and prepare financial analysis on insurance reserve accruals
• Communicate with Human Resources relative to any/all personnel issues
• Assists with other risk management department duties as required

Qualifications, Experience and Education Requirements

• Minimum of 7 years of Workers’ Compensation and/or liability claim handling experience
• Experience managing insurance renewals for property and casualty as well as D&O programs
• Bachelor’s degree – combination of college and professional certifications will be considered
• Has the cognitive ability to problem solve, resolve conflicts, and make decisions with sound reasoning, good judgment, and critical thinking skills
• Has the ability to interpret policies, procedures, governmental rules and regulations
• Has knowledge of the Workers Compensation and Auto Liability system, laws and litigation processes and investigation techniques
• Has knowledge of the tort legal system, litigation processes and investigation techniques
• Ability to organize, schedule, and prioritize tasks to meet deadlines
• Must maintain a high degree of confidentiality
• Excellent verbal, written and people skills 
• Strong financial acumen
• Knowledge of window-based computer operating systems
• Ability to use Origami Risk and Insurance Management Information System (RIMIS) 

Preferred Skills

• Strong technical and administrative skills with attention to details.
• Excellent computer skills and IT competencies. Proficient in Microsoft Access and Excel.
• Ability to understand and design data flow processes. Excellent review and trouble shooting skills.
• Ability to administer multiple customer and internal needs, requirements and deadlines.
• High level of comprehension of contractual verbiage.
• Good communication skills and ability to clearly and concisely respond to customer questions and inquires and to articulate and explain contract application
• Good knowledge and understanding of financial and accounting processes and procedures so to tailor reports and information that can be used for financial accounting needs
• Can work well independently and as part of overall team.