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AIG · 1 day ago

Senior Complex Claims Director - TPA Oversight

Atlanta, GA

Full-time

Onsite

Senior Level, Lead/Staff

10+ years exp

AIG is a global leader in commercial and personal insurance solutions, and they are seeking a Senior Complex Claims Director – TPA Oversight to enhance their claims handling processes. This role involves analyzing and processing bodily injury and third-party property damage claims while ensuring proactive claims handling and effective resolution strategies.

BankingFinancial ServicesInsurance

Responsibilities

Identify and evaluate coverage issues; prepare comprehensive coverage letters with supervisory review and analysis; retain and provide direction to coverage counsel when necessary

Assess liability and resolve claim within established evaluation. Maintain diaries and complete tasks within required timeframes as set forth by department guidelines; ensure claim files are timely and properly documented with clear and concise analysis on coverage, damages, reserves, and liability including an action plan for resolution. Process and pay invoices within a timely manner

Coordinate vendor referrals for additional investigation and/or litigation management. Calculate and assign timely and appropriate reserves; monitor reserve accuracy throughout the life of the claim

Refer case as appropriate to supervisor and management. Respond to requests or directions in a professional and timely manner

Attend arbitrations, mediations, settlement conference and trials

Successfully complete required State licensing examinations and continuing education requirement

Communicate with all internal business partners including underwriters to make sure underwriting is aware of large losses and industry trends

Partner with TPA Governance and Relationship Management to help TPA’s and Insureds comply with claim handling and reporting guidelines

Work with TPA Claims Financial to check the accuracy of TPA financials ensuring alignment with TTPO financials

Qualification

General Liability claimsBodily Injury claimsProperty Damage claimsLitigation claims managementInsurance contract interpretationClaims handling proceduresAnalytical skillsChange initiativesNegotiation skillsCommunication skillsProblem solving skills