Claims Manager

Position: Claims Manager

Location: Springfield, IL

Job : 413

# of Openings: 1

The Claims Manager will coordinate the handling and processing of client claims to proper conclusion, including reviewing for adequacy, completeness, and accuracy. Will also provide guidance, assistance, and follow-up in all aspects of customer claim service requests from management, producers, or clients. Will train and mentor new employees while promoting the Company’s Core Values.

• Conduct detailed reviews of client policy claims for accuracy in completeness, documentation, and signatures; coordinate electronic input of claim transactions, submit loss requests to appropriate carrier adjuster, or to management if under agency draft authority, and ensure documents are delivered/mailed to appropriate parties.
• Prepare requests to clients for additional information if necessary for the processing of claims. Provide education on best outcome. Work closely with carrier and insured to get a timely resolution. Respond to inquiries and complaints from customers in a courteous and professional manner.
• Provide assistance to producers, customer service staff, and management in researching or interpreting insurance claim language and coverage, and likelihood of claim acceptance.
• Maintain frequent contact in person, by phone and mail (electronic/postal), with carriers, producers, clients, and management to facilitate appropriate and professional customer claim service.
• May conduct informational presentations to client employee benefits meetings; may accompany producers to meet with new clients to establish understanding of the claim benefits program.
• Maintain electronic and/or paper files in an orderly, timely manner. Contribute to a suspense system to ensure follow‑up on outstanding or pending business matters.
• Act as a mentor/trainer to new employees including the administrative support staff. Will be in the office during training.
• Responsible for finding efficient ways to work with systems and internal processes. Will give recommendations as needed.
• Actively manage and review claim reserves in partnership with carriers and clients to ensure accuracy, timely adjustments, and optimal financial outcomes, supporting overall client and organizational profitability.
• Handle more complex claims.
• Be a role model for Troxell’s Core Values and exhibit engagement within the team.
• Perform special projects at management’s request.

• High School Graduate or GED required. Advanced training at technical, business, or college level is highly desired.
• 3‑5 years prior account management or claims experience in the insurance industry.
• Experience with handling personal and commercial claims is desired.
• Property & Casualty License and Life & Health License at hire or within 180 days of hire. Must maintain during employment.
• Excellent written and verbal communication skills and enjoy working with people in a high‑volume customer service environment.
• Must be highly organized, yet flexible, in dealing with shifting priorities, fluctuating workloads, and evolving procedures.
• Must be proficient in reading and interpreting complex industry documents such as policy limitations, underwriting standards, and procedure/policy manuals, and apply within prescribed routines and practices.
• Ability to thoroughly analyze product information and make timely and practical recommendations to managers, producers, and clients.
• Ability to work independently with limited supervision while maintaining positive staff relationships within a teamwork environment.
• Must demonstrate competence in computers and office operations. Experience with MS Office products (Word and Excel) and the Internet are highly desirable.

• Full‑time
• Hours are 8:00 am to 4:30 pm
• Travel:
  Minimal

• Work is typically performed in a standard office setting with minimal travel required.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• May be required to work more hours than normally expected during a regular workweek.
• Please note this job description is not designed to cover or contain a comprehensive…