Provides the highest level of technical direction to the claims staff to ensure appropriate outcomes for claims of the most complex nature. Executes quality assurance programs to evaluate staff adherence to the claim handling standards. Develops and ensures compliance with corporate policies and procedures.
Responsibilities:
- Provide technical oversight for unbundled claims assigned to TPA partners inclusive of reserve and settlement authority in excess of TPA discretionary authority limits.
- Provide overflow support to bundled claims handled by PMAIC field claims inclusive of reserve and settlement authority in excess of field authority
- Direct handle an assigned pending of corporately established liability files
- Provide support to various compliance related activities relative to TPA's
- Support Quality Assurance processes to assess quality of work product, identify improvement opportunities and foster discussions that are focused on solutions to enhance results.
- Develops, communicates and ensures compliance with corporate policies and procedures. Leads project teams focused on resolving corporate claims issues.
- Assesses staff training needs and conducts training focused on improving performance.
- Demonstrate commitment to Company’s Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.
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Preferred QualificationsQualifications
- Bachelor's' degree or 5 or more years of equivalent work experience in an insurance related industry required.
- Extensive knowledge of insurance contracts and adjusting techniques. Familiarity with medical terminology.
- Demonstrated leadership, coaching, and teamwork skills.
- Advanced skills in applying sound judgment/analysis, decision making/problem solving, planning and organization and negotiation.
- Demonstrated customer service and collaboration skills.
- Excellent verbal and written communication skills.
- Computer literacy, including working knowledge of MS Office Product Suite, i.e. Word, Excel, PowerPoint.
- Previous supervisory experience, Chartered Property Casualty Insurance (CPCU) and Associate in Claims (AIC), or similar professional designation, desired.
Skills Required
- Bachelor's degree or at least five years of equivalent work experience in an insurance-related industry
- Extensive knowledge of insurance contracts and adjusting techniques
- Familiarity with medical terminology
- Leadership, coaching, and teamwork skills
- Advanced judgment, analysis, decision-making, problem-solving, planning, organization, and negotiation skills
- Customer service and collaboration skills
- Excellent verbal and written communication skills
- Computer literacy and working knowledge of Microsoft Office, including Word, Excel, and PowerPoint
- Previous supervisory experience
- Chartered Property Casualty Insurance designation, Associate in Claims designation, or similar professional designation
PMA Companies Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about PMA Companies and has not been reviewed or approved by PMA Companies.
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Leave & Time Off Breadth — Time off is described as generous, with a sizable PTO bank and a broad paid-holiday schedule. Feedback suggests the ability to accrue and use substantial leave is a standout element of the package.
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Retirement Support — Retirement support includes a 401(k) with company contributions and immediate vesting on certain employer dollars. Profit-sharing and automatic eligibility are positioned as meaningful additions to total rewards.
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Flexible Benefits — Benefits are organized in a cafeteria-style format with multiple medical plan choices, HSA options, FSAs, and a broad set of voluntary coverages. Feedback suggests this flexibility enables tailoring coverage to individual needs.
PMA Companies Insights
What We Do
PMA Companies provides risk management solutions and services, specializing in workers’ compensation and offering property & casualty insurance, in the United States. Headquartered in Blue Bell, PA, PMA Companies is a member of Old Republic Companies. Old Republic International Corporation (NYSE: ORI) is one of the nation’s 50 largest publicly held insurance organizations. PMA Companies includes: PMA Insurance Group, specializing in workers’ compensation, and providing other commercial property & casualty insurance products; and PMA Management Corp. and PMA Management Corp. of New England, providing results-driven TPA and Risk Services specializing in workers’ compensation and liability. We maintain a large client retention rate of 90% or higher and a client satisfaction rate of 96% per an independent survey. At PMA, we still build relationships the "old-fashioned way." Our clients know we care. They know we say what we do and do what we say. And they know that they can count on us to deliver tangible value to their business and to work passionately on their behalf.
