Claims Operation Specialist

Claims TPA Operations Specialist

AXIS is seeking a ClaimsTPA Operations Specialist to join our TPA Programs North America Claims team. As a direct report to the Head of TPA & Program Claims, the successful candidate should be a problem-solver, and self-starter with the ability to support the development and execution of a TPA & Program claims service model for Axis North America TPA & Programs Claims.

The successful Candidate will be responsible for :

Supporting the Head of Program Claims with a variety of responsibilities related to the holistic management of TPAs for North America Claims.

Facilitating TPA relationships and interaction with Axis North America Claims and other internal stakeholders (e.g., North America Claims management, Legal, Finance, Quality Assurance, MGA Operations, Data & Analytics, etc.

through commercial relationship stages (e.g., due diligence assessment, contract negotiation, onboarding, offboarding, claims audits, loss fund management, bordereaux exception resolution, run-off, wind down and, oversight, bordereaux ingestion, etc.)

Identifying and mitigating risks, managing, and resolving workflow, operational, and any other issues related to the operating environment for Axis TPA & Program Claimsmanagement

Scheduling and coordinating meetings with TPA’s, and required stakeholders, building relationships, creating, and tracking action plans

Providing monthly, quarterly, and yearly dashboard reporting on TPA & Program claim metrics, financial impacts, and overall results

Driving initiatives to improve data acquisition, analytics and reporting metrics related to TPAs in partnership with TPAs and internal stakeholders in the development and execution of enhanced reporting, KPIs and scorecards to assist AXIS in understanding ongoing TPA relationships

Developing and updating policies, standards, processes, controls, and related documentation of best practices, guidelines for TPA & Program claims in collaboration and with the direction of North America Claims leadership

Collaborating with Claims Quality Assurance and Compliance to facilitate quality and compliance reviews

Key Skills

3-5 years of experience with TPA managed claims in P&C commercial claims or reinsurance organizations or similar claims oversight operational management or transferable experience

Ability to accomplish tasks in a dynamic environment with an aptitude for analyzing data and making practical and forward-looking decisions to drive success

Excellent communication skills and demonstrated ability and experience supporting strategic initiatives impacting key stakeholders and reporting to senior management

Experience working on cross functional teams, collaborating, actively participating, and delivering solutions

Strong organizational, critical thinking, problem solving, analytical, and quantitative skills including the ability to analyze and interpret financial and claims data

Proven prioritization skills with the ability to balance both the immediate needs with broader organizational strategies

The ability to issue spot and escalate issues that could present challenges to a project or the organization.

College or other relevant experience are a plus

Travel may be associated with this role

For this position, we currently expect to offer a base salary in the range of GA : $75k - 90K; Chicago $85 - 100K; NY $90 - 105K.

The specific salary offer will be based on an assessment of a variety of factors including the experience of the successful candidate and their work location.

In addition, all employees are eligible for competitive incentive targets, with awards based on overall corporate and individual performance.

On top of this, we offer a comprehensive and competitive benefits package which includes medical plans for employees and their families, health and wellness programs, retirement plans, tuition reimbursement, paid vacation, and much more.