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Assistant Vice President - Claims in Kennesaw, GA at Tokio Marine HCC

Date Posted: 9/14/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Kennesaw, GA
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    9/14/2018

Job Description

The Stop Loss Group, a member of Tokio Marine HCC, offers an extensive product portfolio including medical stop loss, group term life and long and short-term disability insurance. We provide the self-insured industry with innovative solutions to protect self-funded employers from potentially catastrophic losses.



Position Summary:

Responsible for the management of various Claims departments, including but not limited to Specific Claims and Aggregate Claims. Ensures that claims processing and claims payment is accurate, efficient, and reserving is appropriate and validated.

Key Responsibilities:

Relying on expert knowledge and advanced leadership skills, the Assistant Vice President, Claims is accountable for the following responsibilities:

  • Interface within the Claims departments and other departments to establish and maintain a high level of communication to policyholders/agents to exceed the client’s expectations.
  • Provide timely, accurate, and high-quality financial reporting services for corporate and management reporting.
  • Oversees the development and operation of actuarially sound claim triage processes in support of divisional financial projections, underwriting, and actuarial functions.
  • Provide direction regarding subrogation.
  • Interpret excess loss policies and plan documents.
  • Assist Managers and/or Supervisors in resolving problems and making various claims decisions, releasing over-limit claims, and handling the proper contractual disbursement of excess loss claims.
  • Educate and train team members in the duties and responsibilities of strong Claims practices.
  • Access in-house resources including the Preliminary and Specialty Claims staff, Actuarial, Underwriting, and Marketing departments to assist in attaining business goals.
  • Manage the work flow of the Claims departments.
  • Communicate in writing and verbally with payors as needed. This includes resolving complex problems of a payors/client.
  • Work with Corporate Legal as a liaison for TMHCC – Stop-Loss Group.
  • Work with data management in streamlining ASO reporting submissions.

 

Planning

  • Direct development of primarily long-term plans for designated area of the organization.
  • Anticipate changes in demand and technologies and adjust strategy to accommodate them.
  • Coordinate resources to ensure strategies are executed.

Communication 

  • Communicate direction or results pertaining to area of responsibility to all levels, internally and externally.
  • Develop company policies and prepare internal/external reports.
  • Present briefings to obtain consensus/approval.

Cost Management

  • Develop and accountable for budget of one or more business units or multiple corporate departments.
  • Set objectives, policies, and procedures for area of responsibility.

Business Controls and Policies

  • Comply with all corporate policies and procedures.
  • Create environment that encourages development and implementation of effective business controls and policies.
  • Allocate resources to ensure proper implementation and monitoring.

People Managemen 

  • Has full HR responsibility for direct reports including making hiring decisions, training, coordinating work, establishing standards, reviewing work, conducting performance appraisals, and providing coaching or counseling.

 



 

Job Requirements



Position Knowledge, Skills, and Requirements: 

Education

  • Bachelor’s degree in Business Administration, a related field, or the equivalent education and/or experience. Master’s degree preferred
  •  

Experience

  • Minimum of twelve years of relevant and progressive experience in medical claims
  • Minimum of eight years of leadership experience
  • Prior experience setting claims reserves

Other

  • Possess and have ability to apply advanced knowledge of principles, practices, and procedures
  • Excellent written and verbal communications skills with an emphasis on confidentiality, tact, and diplomacy
  • Superior organizational and analytical skills; demonstrated ability to manage multiple tasks simultaneously
  • Knowledgeable of industry changes, legal updates, and technical developments related to applicable area of the Company’s business to proactively respond to changing business environment
  • Advanced proficiency and experience using Microsoft Office package (Excel, Access, PowerPoint, Word)


Working Conditions and Physical Demands:

  • Overtime hours may be required to fulfill job responsibilities
  • May require travel outside normal work location
  • May require a valid driver’s license
  • May be required to stoop, bend, or sit for extended periods of time
  • May be required to lift up to 10 pounds
  • Dexterity of hands and fingers to operate a computer keyboard, mouse, and other devices
  • Close vision and ability to adjust focus; required to read a computer screen

Note: This document is intended to describe the general nature and level of work being performed, and is not to be construed as an exhaustive list of all responsibilities, duties, and skills required for the job.

The Tokio Marine HCC Group of Companies offers a competitive salary and employee benefit package. We are a successful, dynamic organization experiencing rapid growth and are seeking energetic and confident individuals to join our team of professionals. The Tokio Marine HCC Group of Companies is an equal-opportunity employer. Please visit www.tmhcc.com for more information about our companies.

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