Claims Executive / Snr Executive

Job Description 1. Support leadership in goal setting and performance delivery Assist the Claims Manager in establishing individual and team goals aligned to departmental KPIs. Drive execution against the team’s objectives through prioritization, tracking, and course-correction as needed. 2. Supervise, coach, and develop claims staff; monitor performance Provide day-to-day supervision, technical guidance, and structured training for Commercial Claims staff. Monitor work quality, cycle times, customer experience outcomes, and operational results; identify performance gaps and implement improvement plans. Conduct ongoing portfolio/file analysis to identify loss drivers, leakage, and opportunities for cost containment while maintaining a high-quality service experience consistent with Sompo standards. 3. Claim assignment, file direction, negotiation, and litigation oversight Assign claims appropriately based on complexity, authority level, and workload. Direct file strategy and development, including investigation, evaluation, negotiations, and timely disposition. Provide oversight and direction on litigated matters, including strategy, settlement posture, and coordination with defense counsel. 4. Handle/guide complex commercial claims and ensure compliance Provide direction and guidance on high-exposure, complex, or sensitive commercial claims. Ensure adherence to corporate claims policies and procedures, statutory/regulatory requirements, and ethical standards. Escalate issues appropriately and ensure documentation supports claim decisions. 5. Coverage guidance and application Partner with claims staff to evaluate coverage issues and ensure accurate policy interpretation and application. Support reservation of rights/denial decisions in alignment with internal guidelines and applicable regulations (as required by authority and process). 6. Stakeholder management and communication Provide regular updates on work in progress, key risks, trends, and operational needs. Maintain strong working relationships with internal business partners and stakeholders (e.g., Underwriting, Actuarial, Finance, Legal, Risk Engineering, Client/Producer teams, TPA partners where applicable) to ensure alignment and continued support. 7. Monthly open file reviews and quality management Perform monthly open-file reviews to assess file quality, compliance, technical accuracy, and service standards. Identify training needs and implement targeted coaching/learning to improve outcomes and consistency. 8. Support hiring, selection, onboarding, and staff development Assist in selection activities (interviews, assessments, recommendations) and onboarding plans. Build staff capabilities through development plans, mentoring, knowledge-sharing, and career progression support. 9. Innovation, automation, and AI-enabled continuous improvement Identify and evaluate opportunities to streamline claims workflows and improve decision quality using automation, analytics, and AI-enabled tools. (e.g., triage/routing optimization, document ingestion and summarization, coverage/letter drafting support, diary/task automation, litigation and severity risk flagging, leakage detection, and customer communication enhancements). Promote responsible use of AI by ensuring appropriate controls for privacy, security, model governance, bias/fairness considerations, auditability, and regulatory compliance. Develop business cases for process improvements (expected benefits, cost/effort, risks, controls), define success metrics, and track impact (cycle time reduction, improved accuracy/consistency, customer satisfaction, indemnity/expense containment). Foster a continuous improvement culture by capturing staff feedback, standardizing best practices, and sharing lessons learned across the team.