Provides legal representation to the organization in insurance claims-related litigation.
Provides legal advice to claims personnel. Leads a staff of internal attorneys and outside legal counsel. Tries large, complex cases as required and directs claims cases through litigation cycle. Consults with senior management to resolve issues and decide settlements. Must be admitted into the state bar. Acts as Attorney of Record.
Job Title | Job Description | |
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1 | Top Human Resources Information System (HRIS) Executive | The Top Human Resources Information System (HRIS) Executive develops, implements, and maintains HRIS system(s) to meet an organization's needs and objectives. Plans and directs all aspects of an organization's human resource information system(s). Being a Top Human Resources Information System (HRIS) Executive requires a bachelor's degree. Researches, evaluates, tests and selects the necessary hardware and software needed to achieve the goals of the department. In addition, Top Human Resources Information System (HRIS) Executive demonstrates expertise in a variety of the field's concepts, practices, and procedures. Typically reports to top management. The Top Human Resources Information System (HRIS) Executive manages a departmental function within a broader corporate function. Develops major goals to support broad functional objectives. Approves policies developed within various sub-functions and departments. Comprehensive knowledge of the overall departmental function. Working as a Top Human Resources Information System (HRIS) Executive typically requires 8+ years of managerial experience. |
2 | Vice President of Claims | The Vice President of Claims is responsible for managing and implementing claims programs for all lines of insurance. Plans and directs all aspects of an organization's insurance claims function. Being a Vice President of Claims develops procedures and policies to enhance and improve the processing, investigation, and settlement of claims. Directs the review and settlement of complex or high dollar claims. In addition, Vice President of Claims ensures legal examinations are made when appropriate. Requires a bachelor's degree. Typically reports to top management. The Vice President of Claims manages a departmental function within a broader corporate function. Develops major goals to support broad functional objectives. Approves policies developed within various sub-functions and departments. Comprehensive knowledge of the overall departmental function. Working as a Vice President of Claims typically requires 8+ years of managerial experience. |
3 | Claim Examinations/Adjustments Manager | The Claim Examinations/Adjustments Manager operates of one or more claims processing units, including the timely and proper disposition of claims in accordance with coverage amounts. Responsible for managing the insurance claims department composed of Examiners and Adjusters. Being a Claim Examinations/Adjustments Manager ensures complete and sound claim settlements, legal reviews and investigations in accordance with company policies and procedures. Oversees insurance claims for personal, property, or casualty loss based on coverage, appraisal, and verifiable damage. In addition, Claim Examinations/Adjustments Manager requires a bachelor's degree. Typically reports to top management. The Claim Examinations/Adjustments Manager typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. Working as a Claim Examinations/Adjustments Manager typically requires 3+ years of managerial experience. |
4 | Claims Payment Clerk I | The Claims Payment Clerk I inputs claim information into system for processing. Reviews insurance claim forms and supporting documents for completeness and accuracy and obtains missing information as necessary. Being a Claims Payment Clerk I calculates settlement amounts according to guidelines. Verifies coverage eligibility. In addition, Claims Payment Clerk I processes routine claim payments. Requires a high school diploma or equivalent. Typically reports to a supervisor. Being a Claims Payment Clerk I works under the close direction of senior personnel in the functional area. Possesses a moderate understanding of general aspects of the job. May require 0-1 year of general work experience. |
5 | Head of Employee Training & Development | The Head of Employee Training & Development collaborates with functional management teams to assess training and development needs as well as to gauge the effectiveness of established programs. Leads the development and implementation of all aspects of an organization's training programs, policies, and objectives to develop and maintain an effective workforce. Being a Head of Employee Training & Development reviews new training techniques and suggests enhancements to existing training programs. Develops a strategic plan to implement an efficient and responsive training services team and relevant programs. In addition, Head of Employee Training & Development oversees relationship with vendors to ensure outside training programs are effective and provide a good return on investment. May lead or contribute to a succession planning process. Requires a bachelor's degree. Typically reports to top human resources management. The Head of Employee Training & Development manages a departmental function within a broader corporate function. Develops major goals to support broad functional objectives. Approves policies developed within various sub-functions and departments. Comprehensive knowledge of the overall departmental function. Working as a Head of Employee Training & Development typically requires 8+ years of managerial experience. |
Skills | Proficiency Level |
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Coordination | Level 4 |
Judgment and Decision Making | Level 5 |
Talent Management | Level 5 |