Sandra Kline Email & Phone Number

New York, Ny, Us

Schaumburg, Il, Us

•Analyzes and processes complex or technically difficult workers' compensation claims in the jurisdictions of PA,DE, VA, and MD. Investigate and gather information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.•Negotiates settlement of claims within designated authority.•Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.•Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.•Prepares necessary state fillings within statutory limits.•Manages the litigation process; ensures timely and cost effective claims resolution.•Coordinates vendor referrals for additional investigation and/or litigation management.•Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.•Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.•Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.•Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.•Ensures claim files are properly documented and claims coding is correct.•Refers cases as appropriate to supervisor and management

Us

•Analyzes and processes complex or technically difficult workers' compensation claims in the jurisdiction of PA, NJ, VA and DE. Investigate and gather information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.•Negotiates settlement of claims within designated authority.•Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.•Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.•Prepares necessary state fillings within statutory limits.•Manages the litigation process; ensures timely and cost effective claims resolution.•Coordinates vendor referrals for additional investigation and/or litigation management.•Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.•Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.•Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.•Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.•Ensures claim files are properly documented and claims coding is correct.

Ch

•Confirms coverage of claims by reviewing policies and documents submitted in support of claims.•Analyzes coverage and communicates coverage positions, as warranted, under direction of supervisor and coverage unit.•Conducts, coordinates, and directs investigation into loss facts and extent of third-party damages.•Directs and monitors assignments to experts and underlying defense counsel.•Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure.•Sets reserves within authority or makes claim recommendations concerning reserve changes to supervisor.•Reports to reinsurers and facilitates the prompt collection of reinsurance on those matters where they are accountable.•Travels to conferences, mediations, and hearings as necessary

Ch

•Ensure the delivery of timely and effective claims service through supervision of a team of examiners and technical assistants at various experience levels•Provide advanced technical guidance on claim investigation, reserving, medical, disability and litigation management, case resolution and settlement strategies•Actively participate in claim committees, account file reviews and project teams to address internal workflows, systems and compliance issues•Demonstrate highly developed analytical, problem-solving and negotiation skills•Develop and maintain strong business relationships with internal and external customers to enhance Chubb's brand in the marketplace•Partner with underwriting, claims business consultant and claims teams to enhance and manage marketing initiatives and customer service commitments•Exhibit strong business acumen to internal and external customers by providing accurate guidance on statutes, regulations, coverages and service issues•Effectively control the use, work product and expenses of outside vendors•Coach team toward effective collaboration with internal resources like Regional Claims Specialist, regional and local nurses, SIU, Recovery and Claims Ops •Exercise leadership by conducting reviews of examiner and technical assistant work product and teamwork efforts to deliver well written, supported performance management feedback and reviews•Show exceptional performance management skills by providing timely coaching and feedback and creating meaningful business goals and development plans•Model exceptional management skills at collaboration, influence, strategic focus, flexibility, communication and accountability•Positively influence the team environment to maintain a high level of employee engagement•Leverage knowledge transfer and training skills for effective staff development toward their personal success and career advancement

Bachelor Of Science - Bs, Marketing

Education record

Bachelor'S Degree, Marketing