Sr Risk Claims Advisor - Remote (Finance)

PURPOSE:

Manages and oversees third-party administrator (TPA) in handling all claims-related matters. Assists in the investigation and processing of [general liability/auto] [workers' compensation] claims with emphasis on litigated and serious exposure claims in accordance with established client service instructions. Protects the Company's best interests by ensuring that risks are properly evaluated and managed, claims are effectively processed in a timely, cost-effective manner, and that TPA provides appropriate claims handling.

ESSENTIAL FUNCTIONS:

• Oversees management of an assigned caseload and works with TPA to investigate, evaluate and resolve claims and manage risks in the Company's best interests within settlement authority
• Assists in the training and coaching of the TPA's adjusting staff, instructing them in the proper performance of work while familiarizing them with client service instructions, expectations and guidelines; recommends changes in client service instructions as appropriate
• Actively manages litigated matters and represents the Company during mandatory settlement conferences, mediations, arbitrations and trials as necessary and in negotiations with attorneys, service companies, insurance companies, etc.; participates in suit intake process to ensure proper distribution and timely response. Assists with preparation and drafting of discovery responses; identifies and reviews internal documents prior to production and works with potential internal witnesses on preparation for depositions and other appearances
• Acts as primary internal contact for claims-related questions and concerns; promptly responds to calls from customers, store associates and division personnel as needed
• Oversees the TPA in proactively handling claims through timely investigations, accurate reserves and resolution-focused action plans and strategy
• Assists in audits of the TPA's work and offers guidance on training opportunities and action plan for performance improvement by TPA. Identifies opportunities to pursue indemnification, contribution or subrogation on behalf of Company and assists TPA with same; provides internal guidance on recovery process and status
• Works with TPA in managing defense attorneys and budgets to ensure aggressive cost control of litigation expenses; provides evaluations of counsel and recommendations for changes to panel list.
• Performs other relevant job duties as required.

JOB REQUIREMENTS:

Education/ Certifications/or Equivalent combination of education training and experience:

• Bachelor's Degree highly preferred

Experience:

• Prior experience as a claims adjuster or extensive experience providing client oversight of TPA.
• Minimum ten years professional claims experience preferred.
• Prior experience managing complex litigation.
• Experience with applicable computer applications is required including PowerPoint and Excel.

Knowledge/ Skills/ Abilities:

• Exhibit excellent communications skills, both verbal and written.
• Demonstrates excellent public relations knowledge and skills.
• Possess ability to work in cooperation with others as a team leader to achieve desired results.
• Must have excellent empathic skills and the ability to deal with conflict.
• Ability to organize and prioritize workload is essential.
• Must be able to handle confidential information in a mature and professional manner while using sound judgment and discretion in processing claims and overseeing the TPA.
• Good judgment is required for this position as there may be times when direct supervision may not be immediately available.

PHYSICAL ENVIRONMENT/ DEMANDS:

• Travel may be required occasionally to attend selected trials, ADRs or for store investigation
• Most work is performed in a temperature-controlled office environment
• Incumbent may sit for long periods of time at desk or computer terminal
• Incumbent may use calculators, keyboards, telephone and other office equipment in the course of normal workday
• Stooping, bending, twisting and reaching may be required in completion of job duties

The above statements are intended to describe the general nature of the work performed by the employees assigned to this job. All employees must comply with Company policy and applicable laws. The responsibilities, duties and skills required of personnel so classified may vary within each department and/or location.

All qualified applicants will receive consideration for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity or expression, national origin, disability, or protected veteran status. UNFI is an Equal Opportunity employer committed to creating an inclusive and respectful environment for all. - M/F/Veteran/Disability. VEVRAA Federal Contractor.