Claims Account Manager (hybrid - Boston Area)

Claims Account Manager (Hybrid - Boston Area)

Position is hybrid (Boston Area).

Knowledge and Experience

• Progressive experience adjusting claims or managing a TPA claim portfolio
• Experienced with delivering and presenting solid data to senior leadership
• Have the ability to engage professionally with interdepartmental and cross functional relationships
• Must be proficient with monitoring set KPIs/Compliance
• Sound experience collaborating with legal representatives on litigated matters

Skills

• Proficient in Excel
• Proficient in Data Analysis and the ability to identify trends, areas for improvement, and opportunities for cost reduction.
• Reporting – prepare regular reports for senior management on the performance of the TPA and the Claims portfolio across multiple lines of business.
• Customer Service and de-escalation skills – occasionally act as liaison between location/TPA/employee/claimant.
• Claims Review – review claims for accuracy, compliance, and possible alternative resolutions. Address requests for increase or settlement within designated financial authority.

Key Accountabilities

• Work with the Senior Director of Claims to monitor the location and TPAs to ensure compliance with existing procedures and KPIs.
• Partner with TPA to identify strategic resolution opportunities.
• Partner with Safety to ensure alignment on procedures, claims trends, and claims prevention opportunities.
• Monitor monthly claims analytics and KPIs.
• Attend monthly meetings to review claims trends and LLRs.
• Assist with tracking and monitoring reserve and IBNR shifts.
• Identify opportunities for early intervention for escalating claims or opportunities to resolve.
• Review TPAs performance results.
• Review location claims performance results.

Additional Statements:

• Drug and alcohol screening: Employment contingent upon passing pre-employment drug and alcohol screen. Also, contingent upon receiving a favorable background check.
• Safety commitment: Safety is a way of life at Keolis. By placing safety first, we ensure the wellbeing of our employees, customers, and communities. Together we can become the most successful transportation company in the world.
• Environmental commitment: Keolis is committed to protecting the environment by minimizing the impact of operations to our people and the communities in which we operate.
• EEO statement: Our policy is to afford Equal Employment Opportunity to qualified individuals regardless of their race, color, sex, religion, age, creed, marital status, national origin, ancestry, physical or mental disability, sexual orientation, or gender identification. We maintain a drug-free workplace and perform pre-employment substance abuse testing.
• Disclaimer and closing statement: The above statements are intended to describe the general nature and level of work performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of employees assigned to this job. Keolis is committed to offering our employees competitive compensation and benefits, opportunities for development and growth throughout an exciting and rewarding career, and the safest work environment possible

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.