Claims Manager Position
4 weeks ago
The Claims Manager will be responsible for driving optimum claims outcomes, supporting operational goals and business objectives, and providing customer service to our stakeholders. This position will oversee third-party adjusting (TPA) company and work with adjusters on claims evaluations, strategy, reserves, and review.
Key Responsibilities:
- Comprehensive Claims Oversight - Manage all claims filed against the organization across various business units and insurance lines. Establish standardized procedures for filing, tracking, and resolving claims.
- Mediation Participation & Litigation Management - Attend mediations as appropriate to provide expert representation and negotiation on behalf of the organization. Work closely with legal teams to develop strategies for effective claim resolution.
- Financial Management - Oversee and manage monthly invoices related to claims. Ensure accurate and timely processing of payments and reimbursements. Monitor and analyze financial data to identify cost-saving opportunities.
- Workers' Compensation Management - Oversee and manage all workers' compensation claims, ensuring timely processing and resolution. Develop and implement effective return-to-work programs to facilitate the prompt and safe return of injured employees. Coordinate with healthcare providers, employees, and supervisors to manage recovery plans and accommodations.
- Efficiency and Resolution - Implement best practices to resolve claims efficiently and effectively. Develop metrics and KPIs to measure performance and improvement in claims management. Foster relationships with insurers, adjusters, and other stakeholders to facilitate smooth claim processes.
- Regulatory Compliance - Ensure all claims are managed in compliance with relevant laws and regulations. Maintain up-to-date knowledge of changes in insurance and claims management legislation.
- Bachelor's degree in a related discipline
- 10+ years of experience as a claims adjuster for workers' compensation claims, auto claims, and general liability
- Knowledge of insurance policies for determining coverage and limits
- Familiarity with multi-jurisdictional adjusting and legal requirements
- Experience with RMIS systems and general Microsoft software
- Superior communication, strategic thinking, and problem-solving skills
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