Claims Team Leader

Key Objective
Supervise and direct the activities of Claims Representatives in the investigation and settlement of claims to ensure prompt, efficient, and fair claims service.

Major Duties and Responsibilities

• Review initial claim notices, assess coverage applicability, and screen cases for flow process eligibility. Determine appropriate next steps for claims with no coverage or questionable coverage.
• Assign work to Claims Representatives and, in coordination with the Claim Vice President or Unit Manager, determine and delegate settlement authority. Retain higher settlement authority as appropriate and refer matters beyond delegated authority to Unit Managers.
• Supervise investigations and oversee claim settlement or disposition by ensuring timely contact with insureds and claimants, prompt investigation, and fair resolution.
• Establish loss reserves to reflect the company’s probable obligation and review and adjust reserves as needed.
• In some cases, directly settle claims based on office size, territory, and workload.
• Evaluate the work of Claims Representatives on open cases or at regular intervals, and provide coaching and guidance to support performance improvement.
• Initiate subrogation or recovery actions as appropriate.
• For litigated claims, coordinate with Claims Attorneys and direct claim-related activities as needed.
• Negotiate and authorize settlements within assigned authority.
• Participate in human resources activities related to direct reports, including performance evaluations, training and development, salary administration, recruitment, and staffing as vacancies arise.

• Strong technical claims knowledge, supported by at least 7-10  years of Construction, Construction Defect and Construction Auto claims handling experience.
• Experience handling claims across multiple jurisdictions; adjuster licenses are preferred.
• Ability to plan, organize, and apply general business and people management practices, supported by management and technical training, college-level coursework, or equivalent related experience.
• Ability to lead change by addressing resistance at the team and individual levels, and to independently evaluate and implement claims management best practices through coaching, training, and mentoring.
• Understanding of team-building principles and continuous quality improvement techniques and how they apply to day-to-day work.
• Strong leadership skills, including the ability to coach, develop, and guide team members toward goals and objectives.
• Excellent communication, negotiation, and interpersonal skills, with the ability to interact effectively with internal and external stakeholders at all levels.
• Strong analytical and problem-solving skills.
• Demonstrated ability to provide consistent, high-quality service to customers.
• Ability to serve as a positive role model for the team by demonstrating accountability, professionalism, and a strong work ethic.

An applicable resident or designated home state adjuster’s license is required for ESIS Field Claims Adjusters.  Adjusters that do not fulfill the license requirements will not meet ESIS’s employment requirements for handling claims. ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam.