ESIS Claims Team Leader, AGL

GENERAL RESPONSIBILITIES:

• Improve the technical quality of files within the team.
• Act as a team facilitator to help remove barriers and take an active role in resolving team issues.
• Be an integral member of the Claims Office Management Team.
• Be responsible for ongoing team development, ensuring effective loss dollar management, and providing value-added customer service.
• Maintain a strong commitment to team building and ESIS management principles.
• Understand and utilize current information systems.
• Collect and analyze data to identify individual opportunities for improvement.
• Work with individuals to assess their knowledge and skill gaps and develop plans for enhancement.
• Promote ESIS Claims Management Division strategies and values.
• Address Human Resource issues and problems effectively.
• Demonstrate a proactive approach to servicing external and internal customers.
• Show understanding and ability to apply the technical aspects of claims handling.
• Provide one-on-one coaching and counseling to team members.
• Effectively evaluate programs and procedures for continuous improvement.

SPECIFIC RESPONSIBILITIES:

• Review and assign all new claims based on customer needs and claim complexity.
• Determine initial reserves and provide direction to representatives as needed.
• Ensure that all coding and documentation are appropriate.
• Follow files according to diaries established by the system as well as individual claim file diaries based on the complexity of the file or customer agreements.
• Review files at key checkpoints for coverage, investigation, subrogation, reserve accuracy, fraud indicators, and provide guidance on ESIS best practices as well as account and carrier requirements.
• Participate in account discussions regarding file issues if they escalate beyond the representative.
• Review status reports for accounts as needed and participate in file reviews as required.
• Manage overall performance for team members, including attendance, file quality, service, and interpersonal issues.
• Ensure reserve adequacy in compliance with ESIS and carrier requirements.
• Participate in litigation strategy sessions.
• Participate in the strategy and management of catastrophic injuries, collaborating with clients, brokers, counsel, representatives, claims vice presidents, home office, carriers, etc.
• Conduct quality audits in addition to individual claim file reviews.
• Provide feedback and responses to carrier, customer, and broker reviews.
• Coordinate training for the team and often for the office on jurisdictional, procedural, carrier requirement, and account requirement topics.
• Resolve concerns from customers, claimants, brokers, or carriers if they escalate beyond the representative.
• Balance caseloads of representatives within the team and across the office.
• Train new hires in all aspects of claims handling.
• Manage the closing of cases to ensure they move quickly and accurately.

• A four-year college degree and/or equivalent work experience or additional degrees (e.g., MBA).
• A high level of technical claims knowledge and competence in Auto/General Liability claims, demonstrated by at least 5 years of claims handling experience at ESIS or within a similar organization.
• Thorough knowledge of Auto/General Liability claims, products, services, and coverages, along with a solid understanding of applicable legal principles.
• Relevant insurance designations such as Associate in Claims (AIC), Associate in Risk Management (ARM), AICPCU, etc.
• Demonstrated effective communication and interpersonal skills to interact with subordinates and all levels of ESIS personnel, as well as attorneys, producers, and accounts.
• A solid understanding of team-building theory and its application to ongoing and planned activities.
• Ability to evaluate the effectiveness of various programs and procedures and incorporate improvements. Ability to facilitate and lead groups of people.
• Demonstrated evaluative thinking by seeking out and considering multiple sources of data to form conclusions and determine courses of action.
• Evidence of strengthening personal effectiveness by demonstrating confidence, credibility, and commitment to established strategies and values.
• Demonstrated creativity and self-motivation in current position and activities through direct claims handling and other related functions.
• Evidence of the ability to manage activities and resource allocation issues, ensuring timely, high-quality service and longer-term payback opportunities related to claims handling processes.

An applicable resident or designated ho