Senior Manager overseeing claims administration at L.A. Care Health Plan. Ensuring accurate and compliant claims processing through effective management and operational control.
About the role
- Supervisor responsible for claims investigation, overseeing claims representatives for City of Hamilton. Ensure compliance and communication with legal entities regarding claims.
Responsibilities
- Reporting to the Manager, Risk Management Services, the Supervisor, Claims Administration will be responsible to oversee the claims investigation and resolution program.
- Provide supervision and performance evaluation of Claims Representatives and Examiners.
- Oversee the claims investigation and resolution program, provide advice and direction to staff and contracted adjusters.
- Directly handle complex or significant claims files.
- Attend claims litigation, mediation, and arbitration proceedings as client representative for the City.
- Responsible for high level communication with legal counsel, City insurers, and re-insurers on all types of property and casualty claims.
- Provide input to the Manager and Corporate Risk Compliance Officer related to the development, maintenance, and evaluation of performance and service level agreements when requested.
- Act as primary Risk Management lead for the provision of recommendations and opinions regarding claim settlements to Senior staff and Council.
- Assist in the monitoring and evaluation of corporate department loss control initiatives as requested.
- Assist in the development and preparation of an informational newsletter for distribution as requested.
- Assist the Manager in the development of the RMS budget.
- Assist the Manager and other designated staff with ensuring the integrity and maintenance of RMS software data base and system reports.
- Develop and maintain a Corporate Risk Management Manual in consultation with the Manager and various user department staff.
- Participate in professional associations, attend various meetings, seminars, and workshops to obtain and exchange beneficial information regarding risk management and insurance.
- Assist the Manager and Corporate Risk Compliance Officer when requested with the management of risk transfer levels and the acquisition of insurance policies and insurance coverage to protect the physical and financial assets of the Corporation and maintain the committed and uncommitted claims reserves (liabilities) as required.
- Negotiate with agents, brokers, and insurance companies with respect to insurance premiums, terms and conditions of all property and liability insurance contracts and renewals, and modifications as required.
- Conduct departmental procedural audits as required and report to the Manager.
- Assist the Manager and Finance staff in analyzing and developing departmental budget charge back allocations.
- Prepare clear and concise administrative reports for senior management, Committees of Council, and Council.
- Attend Council and Committee meetings as required.
- Respond to and resolve inquiries from the public, employees and elected and appointed officials.
- Required to be on call during off work hours to attend to urgent matters, catastrophic incidents and other City emergencies.
- Serve as designate to the Manager as the Risk Management representative for the City’s Emergency Control Group which includes an on-call requirement.
- Attend training as required.
Requirements
- Progressively responsible risk management work experience directly related to the listed job duties normally acquired through the completion of a University Degree in Business or a combination of equivalent education and related risk management work experience.
- Canadian Risk Management designation (CRM) (desired) or equivalent experience.
- Chartered Insurance Professional designation through the Insurance Institute of Canada designation (CIP) or equivalent experience.
- Demonstrated knowledge of Federal, Provincial, and local legislation and regulations such as the Municipal Act, the Negligence Act, the Occupier’s Liability Act, the Insurance Act and the Minimum Maintenance Standards.
- Must have an extensive and broad working knowledge of insurance, government administration, comprehensive risk management principles, statistical analysis, general budget practices, legal proceedings, supervision and training principles.
- Experience in a computerized environment.
- Working knowledge of Word, Excel, database software, Power Point and general computer skills.
- Must have held a senior position of involvement in risk management activities detailed analysis or activity in the areas of insurance policies, coverages, terms and conditions, premiums, loss statistics, loss prevention, finance, insurance law and insurance related contract law.
- Excellent interpersonal skills and be able to communicate effectively orally and in writing with all levels.
- Extensive report writing experience is necessary.
- Must possess a Class "G" driver’s license and provide own vehicle for use on the job.
- Must be able to maintain a high level of confidentiality.
Benefits
- Equal opportunity employer
- Accommodation for applicants in all aspects of the hiring process
Job title
Job type
Experience level
Salary
Degree requirement
Location requirements
Director of Claims Administration leading claims adjudication and compliance processes for L.A. Care. Ensuring operational integrity and regulatory readiness for the healthcare claims ecosystem.
Werkstudent im Projektmanagement und Administration bei Mediaplus in München, verantwortlich für Systemverantwortung, Projektmanagement und Innovationsprozesse.
IT Systemadministrator ensuring system availability for clients at DATAGROUP in a modern IT service environment. Responsible for server infrastructure administration and technical support tasks.
FOS internship in economics and administration at BWF Group. Gaining insights into administrative tasks and supporting daily operations.
HR Administrator managing payroll processes and employee documentation in a tech scale - up company. Collaborating with HR and legal teams to ensure compliance and support employees.
Systemadministrator focusing on information security at WM, a growing family business in automotive parts. Responsibilities include server administration, cybersecurity monitoring, and auditing.
IT Netzwerk Administrator managing and optimizing IT infrastructure and security for Contipark’s operations in Berlin. Leading cloud, network, and security initiatives while collaborating on IT projects.
Relationship Associate managing accounts and driving growth for independent auto dealers. Focusing on customer experience and teamwork to meet branch goals in the Cincinnati/Dayton market.
Special Projects Administrator managing IT projects and supporting business operations at PSI. Coordinating initiatives and tracking deliverables in a fast - paced environment.