Head of Claims TPA Governance - North America

Posted:
8/11/2024, 5:00:00 PM

Location(s):
Alpharetta, Georgia, United States ⋅ Atlanta, Georgia, United States ⋅ Georgia, United States

Experience Level(s):
Senior

Field(s):
Legal & Compliance

Workplace Type:
On-site

At AIG, we are reimagining the way we help customers to manage risk. Join us as Head of Claims TPA Governance - North America to play your part in that transformation. It’s an opportunity to grow your skills and experience as a valued member of the team.

Make your mark in Claims

Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we take pride in delivering responsive, fair and professional service with empathy and efficiency.

How you will create an impact

This position will lead the North America (NA) team to ensure that all NA Third Party Administrators (TPAs) provide high quality claims management to AIG and its clients through adherence to AIG’s Claim Service Agreement and Claim Handling Guidelines.  This role is responsible to identify and mitigate AIG’s risk related to third party administrators by ensuring effective control and oversight strategies are in place and consistently executed. The role will report directly to AIG’s Global Head of Claims Third Parties, as well as engaging directly with Claims and Underwriting Exec.

The position is the “go-to” source for the NA business in relation to TPAs, through knowledge of the claims operational/technical processes and the AIG/TPA business relationships.  The role requires the ability to balance the needs of multiple stakeholders, making sound decisions, utilizing your claims experience, judgment, and risk mitigation mindset.  The role has ownership for key TPA performance outcomes, overall management of TPA state regulatory compliance with a heavy emphasis in the workers’ compensation line of business, to include regulatory interaction/responses and overall issue resolution/direction related to TPA claim matters. 

The ideal candidate will lead the NA TPA Function to drive TPA claim compliance and performance, in partnership with various business units and stakeholders including Finance, Legal, Underwriting, Claims Engagement and Claim Technical Oversight.

Position Key Activities

  • Lead TPA Governance team to ensure NA TPAs comply with AIG’s Global Third Party Risk Management Policy and Standards.
  • Lead the governance oversight/management of all NA TPAs.
  • Work with Underwriting and Program Managers to secure renewals and new business opportunities for “unbundled business” through the use/approval of TPAs.
  • Drive due diligence requirements for TPA onboarding to include onsite competency evaluations to ensure TPA meets AIG fitness requirements.
  • Partner with Legal to ensure contracts are in place for all NA TPAs.
  • Serve as an escalation point of contact for issue resolution that put the AIG customer/client experience at risk related to TPAs.
  • Partner with designated business groups in the management of client File Transfers (TPA to TPA Transfers/AIG to TPA or TPA to AIG). 
  • Communicate and/or educate TPAs regarding applicable AIG claims procedures, protocols and claim handling expectations.
  • Oversee the tracking and evaluation of TPA performance through onsite operational audits, coordination with AIG’s technical claim audits and TPA key claim performance metrics.
  • Oversee TPA remediation activities/action plans as necessary to address poor performance.
  • Develop materials and lead NA TPA Steering Committee and manage communications to key stakeholders around key issues / resolutions.  
  • Lead relationships with AIG’s strategic TPAs.
  • Ensure accurate and timely responses / support to internal/external audits (PWC, State Regulatory, etc)
  • Drive Strategic TPA Relationship sessions with strategic TPAs and NA Claims Leadership.

What you'll need to succeed

  • 10+ years of experience in Claims Team Leadership/Management/Technical Claims Handling.
  • Bachelor’s degree preferred.
  • Strong claims and claims operational background. 
  • Strong understanding of the insurance industry/market.
  • A record of providing outstanding claim service and customer service experience.
  • Excellent verbal and written communication skills with strong influencing communication skills.
  • Experience in conflict resolution, or the ability to de-escalate tense situations - comfortable in a role that requires negotiation.
  • Analytical skills, resourceful with the ability to search and find answers/market data as needed.
  • Results oriented, and able to work well under pressure.
  • Excellent organizational skills – very flexible with moving from project to project while keeping track of progress.
  • Professional attitude - we are looking for someone enthusiastic, reliable, and a team player.
  • Demonstrates a high level of interpersonal skills; skilled at relationship building.
  • Strong focus and demonstrated commitment to team work/team development.
  • Experience leading and influencing others through change and ever increasing responsibilities.
  • Demonstrates leadership skills to manage and drive solutions.
  • Ability to self-start, work independently and consistently meet deadlines.
  • Proven ability to drive results though accountability.
  • Strong problem solving skills/proven capability to develop and implement solutions.
  • Relationship/Partnership/Account management background – a plus.
  • Proficiency with MS Office software, Excel and PowerPoint.

Ready to take your career to the next level?  We would love to hear from you.

#LI-AIG #claimsprofessionals #claims

Enjoy benefits that take care of what matters

At AIG, our people are our greatest asset. We know how important it is to protect and invest in what’s most important to you. That is why we created our Total Rewards Program, a comprehensive benefits package that extends beyond time spent at work to offer benefits focused on your health, wellbeing and financial security—as well as your professional development—to bring peace of mind to you and your family.

Reimagining insurance to make a bigger difference to the world

American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the world’s most far-reaching property casualty networks. It is an exciting time to join us — across our operations, we are thinking in new and innovative ways to deliver ever-better solutions to our customers. At AIG, you can go further to support individuals, businesses, and communities, helping them to manage risk, respond to times of uncertainty and discover new potential. We invest in our largest asset, our people, through continuous learning and development, in a culture that celebrates everyone for who they are and what they want to become.

Welcome to a culture of belonging

We’re committed to creating a culture that truly respects and celebrates each other’s talents, backgrounds, cultures, opinions and goals. We foster a culture of inclusion and belonging through our flexible work arrangements, diversity and inclusion learning, cultural awareness activities and Employee Resource Groups (ERGs). With global chapters, ERGs are a cornerstone for our culture of inclusion. The diversity of our people is one of AIG’s greatest assets, and we are honored that our drive for positive change has been recognized by numerous recent awards and accreditations.

AIG provides 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.

AIG is committed to working with and providing reasonable accommodations to job applicants and employees with disabilities.  If you believe you need a reasonable accommodation, please send an email to [email protected].  

Functional Area:

CL - Claims

Estimated Travel Percentage (%): Up to 25%

Relocation Provided: No

AIG Claims, Inc.

American International Group

Website: https://aig.com/

Headquarter Location: New York, New York, United States

Employee Count: 10001+

Year Founded: 1919

IPO Status: Public

Industries: Commercial Insurance ⋅ Financial Services ⋅ Health Insurance ⋅ Insurance ⋅ Lending ⋅ Life Insurance ⋅ Property Insurance ⋅ Real Estate Investment ⋅ Retirement ⋅ Risk Management