Manager, Claims

Summary

Manages the daily operations of the Claims Department to achieve growth and underwrite profitability goals.

• Manages a multi-functional unit of claim professionals and support staff.
• Leads claim team in support of department initiatives and strategies in cost containment, case file handling, customer service, and quality.
• Consistently monitors workflows to maximize accuracy and efficiency. Maintains an acceptable level of service and customer satisfaction and retention.
• Effectively manages the quality review process.
• Develops unit goals, objectives, processes, procedures, and systems.
• Stays abreast of changes in workers’ compensation statutes, case law, and rehabilitation advancements.
• Identifies team staffing needs and takes necessary measures to ensure appropriate levels of service. Mentors employees and develops career paths with growth opportunities.
• Participates in development of the annual departmental budget, monitors budget, and identifies budget discrepancies. Researches causes of discrepancies and makes recommendations.
• Participates in special projects and serves on committees as needed.

• Relevant combination of education and experience may be considered in lieu of degree.
• Bachelor’s degree in a related field.
• Seven (7) years of experience in a claims environment with demonstrated technical experience that provides the necessary knowledge, skills, and abilities.
• Three (3) years of supervisory or leadership experience in claims required.
• Previous workers’ compensation claim management with multi-jurisdictional experience preferred.
• Bilingual skills preferred.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

• Knowledge of team building and employee motivation theories with the ability to effectively manage multi-functional employee teams.
• Demonstrated leadership abilities.
• Knowledge of laws, regulations and compliance requirements related to workers’ compensation insurance.
• Demonstrated technical knowledge of insurance administration, claims management or relevant insurance expertise.
• Ability to work with and empower others on a collaborative basis to ensure success of the unit team.
• Excellent oral and written communication skills.
• Knowledge of insurance and underwriting techniques, agency, and policyholder needs.
• Ability to effectively present budgetary and/or cost information and respond to questions as appropriate.
• Ability to establish workflows, manage multiple projects and meet necessary deadlines.
• Ability and proficiency in the use of computers and company standard software specific to the position.

Directly supervises a varied number of employees in the designated department(s). Carries out supervisory responsibilities in accordance with the organization’s policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. This job description does not constitute a contract for employment.

Actual compensation decision relies on consideration of internal equity, candidate’s skills and professional experience, geographic location, market, and other potential factors. It is not the standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $94,500 and $158,350.

We are an Equal Opportunity Employer. We will not tolerate discrimination or harassment in any form. Candidates for this position are hired on an "at will" basis. Nothing herein is intended to create a contract.