Claims Manager

1 month ago

Dallas, United States Qualitas Insurance Full time
Job DescriptionJob Description

Job Description

 

 

Job Title:                            Claims Manager

Shift:                            Full Time, Exempt

Reports To:                 Claims Director

Date Prepared:           7/26/2024

 

 

SUMMARY:

 

The Claims Manager is responsible for providing training, development, and guidance to assigned staff to ensure effective resolution of commercial and personal auto claims. The Claims Manager will supervise claims professionals working both remotely and in a hybrid environment. The ideal candidate will be a self-driven, independent thinker and problem solver that works with minimal supervision.

 

 

ESSENTIAL DUTIES AND RESPONSIBILITIES

 

·         Select, train, develop, motivate, and lead a team of in- house claims professionals

·         Evaluate, coach and discipline staff as needed

·         Conduct annual performance reviews

·         Manage assigned Claims Supervisor(s) and/or Claims Examiners

·         Oversees assignment of new claims according to severity or appropriate criteria

·         Develop, implement, and monitor the effectiveness of programs designed to control costs related to auto and liability claims

·         Participates in review of departmental procedures, suggests improvements or changes as appropriate

·         Participates in large loss roundtable

·         Monitor and approve reserves and payments as needed

·         Monitors and upholds customer service standards, responds to escalated claims-related complaints or inquiries

·         Ensure all claim related matters are handled in accordance with legal obligations and in compliance with applicable laws, rules, and regulations

·         Assist in response to Department of Insurance complaints and inquiries

·         Develop, implement, manage, and monitor the controls over reporting, audit tools, payment of claims, and respond to internal and external audits of processes, procedures, and controls

·         Assist senior management in the development and tracking of performance metrics

·         Comply with all applicable laws/ regulations, as well as company policies and procedures

·         Perform other duties as required

 

 

 

 

 

 

Qualifications

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 accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

·         Minimum of 10 years of claims handling experience, including significant exposure to the investigation and resolution of coverage issues

·         Prior team lead or supervisory experience, preferably including both litigated and non-litigated claim files.

·         Must have claims-related computer systems experience

·         Excellent verbal and written communication skills- including presentation skills and public speaking

·         Comprehensive knowledge of insurance policy provisions, practices, laws, and regulations

·         Ability to interpret laws and regulation, determine appropriate course of action, present solutions, and resolve claims

·         Strong interpersonal skills

·         Strong customer service skills with a positive attitude

·         Ability to follow and execute directions

·         Experience managing claims across multiple jurisdictions including California, Texas, and Arizona, is preferred

·         Commercial auto and/or nonstandard personal auto experience required

·         Bilingual (Spanish) Preferred, not required

 

 

 

 

Education or Experience

 

·         10 years of experience in claims handling, 3 years of supervisory experience

·         College degree or equivalent work experience

·         SCLA/ AIC designation preferred, but not required

 

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