Life Science & Digital Health Claims Manager
$130k - $160kBeazley Group
Job Title: Life Science & Digital Health Claims Manager
Division: Group Claims
Location: United States
Reports To: As per Beazley's organization chart
Key Relationships: Group Claims Management Team, Claims Team Leaders ("CTLs"), Underwriting & Claims Operations ("UCO"), Underwriters, Ceded Reinsurance, clients, brokers, and key external vendors.
Job Summary: An independent claims handler who will manage and oversee the end-to-end claims process for a wide variety of matters under healthcare professional liability policies. Supports Beazley's vision of being the highest performing sustainable specialty insurer through proactively managing claims, at an individual and portfolio level where required.
Key Responsibilities:
Individual Claims Management
- Proactively manage a diverse portfolio of healthcare professional liability claims.
- Handle claims from first notice of loss through resolution, assessing severity, complexity, and direct financial loss to determine the appropriate level of involvement based on claim type, maturity, and quantum, while working closely with brokers, insureds, and underwriting partners.
- Evaluate policy coverage in line with underwriting intent, draft clear and well-reasoned coverage position letters, and effectively communicate coverage determinations to brokers, insureds and other relevant stakeholders in accordance with Beazley's Claims Service Standards.
- Manage portfolio of medium to high severity claims, including Category 2 and some Category 1 claims (i.e., claims with an expected or actual value in excess of $500,000 or having material coverage issues) including (depending on training and agreement of the Head of) Coverage Litigation but without allegations of bad faith.
- Review of individual claims within the portfolio on a regular basis ensuring claims records are maintained in a timely manner as required by Beazley's claims controls and standards as well as regulatory minimums.
- Establish appropriate and timely case reserves adhering at all times to Beazley's authority protocols and Beazley's Claims Reserving Philosophy and Standards while using all tools available to demonstrate potential loss exposure.
- Develop, iterate, document, and execute claims strategies taking into account uncertainties, key decisions, potential outcomes, and estimated associated costs.
- Ensure the management of claims conforms to the agreed standardized processes, maintain accurate and updated claims files including proper documentation and data.
- Communicate any material claims to Reinsurance and Finance as set out by the applicable claims authority, claims controls/protocols, and procedures.
- Working with Reinsurance to effect claims recoveries.
- Understand and implement Beazley's Conduct Risk Policy.
- Contribute to the continuous improvement culture within the overall claims function.
Strategy and Business Planning
- Maintain an awareness of the overall strategic objectives and business plans of the Beazley claims function to the degree required to identify gaps or future opportunities to Claims Management.
Working with Underwriters and Claims Team
- Understand marketing and underwriting strategies for the business area.
- Where requested, join client meetings to share Beazley's claims philosophy and address specific claims issues.
- Provide input to underwriters of potential or existing insured's claims experience.
- Identify issues and trends, consult relevant stakeholders if required, and take appropriate and/or corrective action.
- Identify wordings issues and suggest policy wording improvements.
- Leverage networking opportunities within the business to develop standardized underwriting policy and best practices within Beazley.
- Work with Claims team members and underwriters to maximize business opportunities and profitability within the department including sharing market information, marketing sources and cross-selling opportunities.
- Help produce presentations and marketing literature as required.
Authority & Minimum Standards Observance
- Operate within approved claims authority at all times.
- Maintain a thorough knowledge of and ensure compliance with relevant regulation, minimum claim handling standards and Beazley's claims controls and protocols.
Third Party Management
- Adhere to Beazley's procedures for the selection and retention of 3rd party professionals.
- Where applicable, appropriately manage escalation of items from delegated partners.
- Where applicable, conduct file reviews or audits as required, and resolve any issues identified.
- Where applicable, provide feedback on a regular and proactive basis regarding the claim actions undertaken by the Third-Party Administrator (TPA).
- Where applicable, propose strategies for future claims handling, review case reserve adequacy, and ensure the TPA remains focused on claim finalization.
Broker and Insured Relations
- Work proactively to develop and maintain strong relations with key brokers and insureds.
- Promote the Beazley brand of excellence and professionalism in client service.
Conflicts of Interest
- Adhere to Beazley's Conflicts of Interest policy, alert the appropriate person to any potential conflicts of interest, and take steps to resolve them promptly.
- Immediately advise your Head of or Group Head of Claims if any Beazley employee seeks to exert undue influence on you or any other team member to act improperly in the management, reserving, or settlement of any claim.
General
It is important that within all your interactions both internally and externally you adhere to Beazley's core values - Being Bold, Striving for Better, and Doing the Right Thing - as they contribute to an internal environment of teamwork and promote a positive brand image and experience to our external customers. We also expect Beazley employees to:
- Comply with Beazley procedures, policies and regulations including the code of conduct, which incorporates the PRA and FCA Conduct.
- Undertake training on Beazley policies and procedures as delivered by your line manager, the Culture & People or assurance teams (compliance, risk, internal audit) either directly, via e-learning or the learning management system.
- Display business ethics that uphold the interests of all our customers.
- Ensure all interactions with customers are focused on delivering a fair outcome, including having the right products for their needs.
- Comply with any specific responsibilities necessary for your role as outlined by your line manager, the Culture & People or assurance teams (compliance, risk, internal audit) and ensure you keep up to date with developments in these areas. This may include, amongst others, Beazley's underwriting control standards, Beazley's claims control standards, other Beazley standards and customer relationship management.
- Carry out additional responsibilities as individually notified, either through your objectives or through the learning management system. These may include membership of any Beazley committees or working groups.
Education and Qualifications
- College degree. J.D. preferred but not required.
- Five or more years of experience handling professional liability claims, preferably in medical malpractice.
- Adjuster license(s) may be required as part of your job responsibilities. If required, those licenses must be obtained within the first 90 days of your employment and in accordance with an individual licensing plan established by Beazley Compliance and your Manager.
Skills and Abilities
- Analytical skills: Problem solving (broad-based, analytical, conceptual, creativity), analysis of financial statements, financial assessments of claims, data analysis and decision-making
- Work management skills: Time and workload management, self-starter, planning, achievement orientation, productivity focused
- Interpersonal skills: Ability to influence others, client and broker management skills, purposeful communication, flexibility, active listening
Knowledge and Experience
- Legal training or claims experience, including assessing liability and negotiating settlements.
- Functional expertise includes: claims management procedures, knowledge of both US and international insurance markets (general and specialised areas), familiarity with US and global legal and regulatory frameworks, as well as alternative dispute resolution methods.
Competencies
- Problem-solving
- Decisiveness
- Customer-focused
- Influencing others
- Attention to detail
- Team work
- Self-starter
- Analytical thinking
- Managing resources effectively
Who We Are:
Beazley is a specialist insurance company with over 30 years' experience helping people, communities and businesses to manage risk all around the world. Our mission is to inspire our clients and people with the confidence and freedom to explore, create and build - to enable businesses to thrive. Our clients want to live and work freely and fully, knowing they are benefitting from the most advanced thinking in the insurance market. Our goal is to become the highest performing sustainable specialist insurer.
Our products are wide ranging, from cyber & tech insurance to marine, healthcare, financial institutions and contingency; covering risks such as the weather, film production or protection from deadly weapons.
Our Culture
We have a wonderful mix of cultures, experiences, and backgrounds at Beazley with over 2,000 of us working around the world. Employee's diversity, experience and passion allow us to keep innovating and moving forward, delivering the best. We are proud of our family-feel culture at Beazley that empowers our staff to work from when and where they want, in an adult environment that is big on collaboration, diversity of thought and personal accountability. Our three core values inspire the way we work and how we treat our people and customers.
- Be bold
- Strive for better
- Do the right thing
Upholding these values every day has enabled us to become an innovative and responsive organization in touch with the changing world around us.
We are a flexible and innovative employer offering a friendly, collaborative, and inclusive working environment. We actively encourage and expect applications from all backgrounds. Our commitment to fostering a supportive and dynamic workplace ensures that every employee can thrive and contribute to our collective success.
Explore a variety of networks to assist with professional and/or personal development. Our Employee Networks include:
- Beazley RACE - Including, understanding and celebrating People of Colour
- Beazley SHE - Successful, High potential, Empowered women in insurance
- Beazley Proud - Our global LGBTQ+ community
- Beazley Wellbeing - Supporting employees with their mental wellbeing
- Beazley Families - Supporting families and parents-to-be
We encourage internal career progression at Beazley, giving you all the tools you need to drive your own career here, such as:
- Internal Pathways (helping you grow into an underwriting role)
- iLearn (our own learning & development platform)
- LinkedIn Learning
- Mentorship program
- External qualification sponsorship
- Continuing education and tuition reimbursement
- Secondment assignments
The Rewards
- The opportunity to connect and build long-lasting professional relationships while advancing your career with a growing, dynamic organization
- Attractive base compensation and discretionary performance related bonus
- Competitively priced medical, dental and vision insurance
- Company paid life, and short- and long-term disability insurance
- 401(k) plan with 5% company match and immediate vesting
- 22 days PTO (prorated for 1st calendar year of employment), 11 paid holidays per year, with the ability to flex the religious bank holidays to suit your religious beliefs
- Up to $700 reimbursement for home office setup
- Free in-office lunch, travel reimbursement for travel to office, and monthly lifestyle allowance
- Up to 26 weeks of fully paid parental leave
- Up to 2.5 days paid annually for volunteering at a charity of your choice
Salary for this role will be tailored to the successful individual's location and experience. The expected compensation range for this position is $130,000 - $160,000 per year plus discretionary annual bonus.
Don't meet all the requirements? At Beazley we're committed to building a diverse, inclusive, and authentic workplace. If you're excited about this role but your experience doesn't perfectly align with every requirement and qualification in the job specification, we encourage you to apply anyway. You might just be the right candidate for this, or one of our other roles.
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