Job Description
The individual shall provide the name of the individual designated to maintain and handle litigated claims, inclusive of, but not limited to Third Party Administrator Services
(i) This individual shall be highly experienced in these areas and shall assist the contractor in oversight of all litigated claims, and shall have significant input within the area of litigation management.
(ii) This individual shall have ten(10) years of experience adjusting and/or administering litigated claims for a public agency.
(iii) Individuals holding designations such as Associate in Risk Management for Public Entities (ARM-P) are preferred.
The individual shall create a review system to ensure accurate data will be entered into the claims management system. All claims must be reviewed periodically to be determined by OGC and RM. The review system will include a check on all the financial documentation entered into the claims management system to ensure the financial integrity of the system. In addition, the review system must include appropriate claims handling and reserving procedures and timely file closures.
The individual shall review pertinent and/or highly sensitive NFPHC claims with RM and designated OGC personnel or other NFPHC officials to discuss the ongoing claims and litigation status and make strategic recommendations.
The individual shall cooperate, assist, and meet with auditors and actuaries reviewing the NFPHCs and the TPA’s system and records. TPA will provide documents to auditors and actuaries upon request. To ensure a high-quality work product, TPA will also cooperate, assist, and meet with RM regularly on a schedule determined by RM.
The individual shall provide comprehensive claims and litigation management and administration, including assuming the handling of existing open claims and lawsuits. This will include case management, defense management, and settlement/negotiations. All claims are to be managed to their final conclusion.
The RM must approve all investigating and expert firms retained by the TPA. The NFPHC reserves the right to change an investigation firm, expert, or similar service provider related to handling claims that may be recommended by TPA.
The individual shall ensure that the services provided by outside counsel are in accord with the NFPHC’s contract and Billing Guidelines for outside law firms on the eBilling platform.
The individual shall proactively manage NFPHC claims and lawsuits, identify loss trends, and suggest steps that might be taken to mitigate future claims.
The individual shall be required to report to the NFPHC any assigned claims determined to present a potential conflict of interest. TPA will not represent the NFPHC where a conflict may exist without a written waiver from the NFPHC.
The individual will also provide trend analysis reports to assist in identifying potential risks.
The individual shall be knowledgeable in the area of loss prevention and assist RM with applicable reports to identify potential safety and risk issues.
Company Description
Imperial Cyber Group LLC is a multi-disciplinary managed services company with expertise in information technology services. We specialize in Network Engineering, Cybersecurity, and intelligence analysis, in which we offer a vast range of professionals. We tailor our services to protect the mission of our customers, which is our primary focus. In today’s world, with the constant threat of compromise, security is of the highest magnitude of concern for the safety and integrity of our customer’s unique needs.