ESIS Claims Vice President

JOB DESCRIPTION

KEY OBJECTIVE:
Responsible for overseeing claim activities for the Mid-Atlantic workers' compensation regional operation, ensuring quality and timely claims service in a cost-effective and equitable manner.

Implements quality plans, monitors outcomes, and recommends corrective actions.

Provides technical oversight, including managing the claims process and supporting the resolution of account-related issues.

ROLES & RESPONSIBILITIES


* Support the management of the Monthly Quality Self-Review Process.


* Assist with audits on Performance Guarantee Accounts, track trends, and help develop and implement proactive action plans to ensure compliance with Performance Guarantees.


* Utilize Excel proficiency to identify and analyze trends, collaborating with the claims department to address findings.


* Assist with completion of internal self-audit compliance reviews.


* Help coordinate monthly penalty log updates and staffing reports.


* Support training for new hires and ongoing training for current employees.


* Coordinate hiring, training, and onboarding processes.


* Assist team leaders and claims handlers with special projects (e.g., reserve analysis, account-specific projects, closing projects, workbook audits).


* Participate in file reviews and new account presentations as needed.

Monitor and report on aged queues (Apollo, OMNI, MBR, etc.).
+ Attend sales presentations.
+ Evaluate and analyze caseloads and staffing requirements.

REPORTING RELATIONSHIPS:
Reports to and receives direction from the Claims Senior Vice President (SVP).

QUALIFICATIONS

Colleague Development:


* Actively seeks opportunities to develop new skills and expand knowledge for both self and team members.


* Supports and fosters a team environment that encourages continuous feedback and the sharing of ideas.


* Participates in external professional associations to contribute expertise and enhance technical skills.

Teamwork:


* Engages in team planning and implementation activities, openly sharing information and expertise to achieve group objectives.

Knowledge:


* Bachelor's degree or equivalent professional experience required.


* Minimum of ten years of experience in workers' compensation claims handling or supervision, with a focus on advanced technical skills.

Skills:


* Strong research and analytical abilities; able to define challenges and identify effective solutions.


* Excellent organizational and resource management skills, including managing people, projects, and time.


* Effective oral and written communication skills.


* Ability to maintain client relationships and identify business opportunities.


* Proficient in company-approved software and systems, as well as relevant internet applications.


* High attention to detail.


* Proficient in English (speaking, reading, and writing).


* Demonstrated ability to manage and lead staf...