What you need to know:Oversees claim specific TPA activities involving policy coverage and management of indemnity, medical and legal aspects of highest valued, complex claims. Reviews and analyzes TPA claim financials to ensure payments are appropriate and accurately coded, deductibles/retentions are properly eroded, and excess reimbursements are processed timely and accurately. Completes an independent analysis and evaluates claim exposure on assigned files with a focus on establishing appropr... more details
Claims Management Analyst- Workers Compensation
Who we Are
American International Group, Inc. (AIG) is a leading global insurance organization. AIG member companies provide a wide range of property casualty insurance in approximately 70 countries and jurisdictions. These diverse offerings include products and services that help businesses and individuals protect their assets and manage risks.
We’re also committed to making a positive difference for our colleagues and in the communities where we work and live. We encourage colleagues to give back to the causes they care most about, supporting these efforts through our Volunteer Time Off and Matching Grants Programs.
Get to know the business
General Insurance is a leading provider of insurance products and services for commercial and personal insurance customers. It includes one of the world’s most far-reaching property casualty networks. General Insurance offers a broad range of products to customers through a diversified, multichannel distribution network.
Our Claims professionals support AIG policyholders through some of the most trying times. When our clients face losses large and small, we step up to help them ease the financial burdens of catastrophic events like fires and hurricanes; we help them get their businesses back up and running again or recoup the value of a lost family heirloom or a prized possession. Our Claims team is an industry leader, drawing daily on its unparalleled levels of expertise to offer our clients the highest levels of stewardship to drive total cost of claim improvement and consistent outcomes. AIG manages claims using a wealth of technical and market knowledge about risks, business practices, and the ever-evolving legal and regulatory environment.
About the team:
The AIG Technical Third Party Oversight (TTPO) team is a group of highly skilled and dedicated claim professionals with an average of 28 years WC claim handling experience. We collaborate with external TPAs and internal stakeholders to achieve optimal outcomes on complex and catastrophic WC claims. This position provides the opportunity to engage/work with senior claim and underwriting management, and for growth within the company.
About the role:
What you need to know:
- Oversees claim specific TPA activities involving policy coverage and management of indemnity, medical and legal aspects of highest valued, complex claims.
- Reviews and analyzes TPA claim financials to ensure payments are appropriate and accurately coded, deductibles/retentions are properly eroded, and excess reimbursements are processed timely and accurately.
- Completes an independent analysis and evaluates claim exposure on assigned files with a focus on establishing appropriate reserves within assigned authority ($200,000) and in recognition AIG’s of exposure above the deductible. Continually evaluates reserves during life of the claim to ensure accuracy of financial exposure. Identifies and makes reserve recommendations to management on claims evaluated greater than assigned authority.
- Works with, and provides direction to, TPAs to develop resolution strategy plans (action plans). Continually assesses and updates plans to achieve appropriate claim results and timely closure. Provides settlement authority to TPAs and oversees negotiations to achieve claim settlements within authority limits.
- Reviews claims for subrogation opportunities and evaluates requests for WC lien waivers.
- Acts as technical expert responsible for completion of Major Loss Reports (MLRs) for assigned cases detailing significant reserve activity and disposition strategies on the highest value/most complex claims
- Communicates with internal and external customers on complex technical issues and participates in external customer claim file reviews and audits as required.
- Investigates TPA E&O and pursues recovery, where applicable.
What we’re looking for:
- Ten (10) or more years of workers compensation claim handling experience
- Bachelor’s degree from a four year college or university
- Ability to make independent decisions within prescribed authority limit
- Strong (oral/written) communication and interpersonal skills
For positions based in Jersey City, NJ, Concord, CA, Los Angeles, CA and Irvine, CA the base salary range is $78,000-$103,000. For positions based in San Diego, CA, the base salary range is $78,000-$99,000. In addition, the position is eligible for a bonus in accordance with the terms of the applicable incentive plan.? In addition, we’re proud to offer a range of competitive benefits, a summary of which can be viewed here: AIG Benefits Overview.
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A look at our Benefits
We're proud to offer a range of employee benefits and resources that help you protect what matters most - your health care, savings, financial protection and wellbeing. We provide a variety of leaves for personal, health, family and military needs. For example, our "Giving Back" program allows you to take up to 16 hours a year to volunteer in your community. Our global mental health and wellness days off provide all colleagues with a paid day off to focus on their mental health and wellbeing.
We also believe in fostering our colleagues' development and offer a range of learning opportunities for colleagues to hone their professional skills to position themselves for the next steps of their careers. We have a tuition reimbursement program for eligible colleagues to enhance their education, skills, and knowledge in areas that relate to their current position or future positions to which they may transfer or progress.
We are an Equal Opportunity Employer
American International Group, Inc., its subsidiaries and affiliates are committed to be an Equal Opportunity Employer and its policies and procedures reflect this commitment. We provide equal opportunity to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national origin, veteran status, disability or any other legally protected categories such as sexual orientation. At AIG, we believe that diversity and inclusion are critical to our future and our mission – creating a foundation for a creative workplace that leads to innovation, growth, and profitability. Through a wide variety of programs and initiatives, we invest in each employee, seeking to ensure that our people are not only respected as individuals, but also truly valued for their unique perspectives.
To learn more please visit: https://www.aig.com/about-us/diversity-equity-and-inclusion
AIG is committed to working with and providing reasonable accommodations to job applicants and employees with physical or mental disabilities. If you believe you need a reasonable accommodation in order to search for a job opening or to complete any part of the application or hiring process, please send an email to candidatecare@aig.com. Reasonable accommodations will be determined on a case-by-case basis.
CL - Claims
Estimated Travel Percentage (%): No Travel
Relocation Provided: No
AIG Claims, Inc.
