Manager of Claims Review

2 weeks ago

New Braunfels, Texas, United States The Ladders Full time
Job Overview

The Claims Examination Supervisor at The Ladders is tasked with overseeing the daily operations of the Claims Examiners to guarantee effective workflow, precision, and adherence to regulations. This role involves managing litigation claims and collaborating with legal representatives while supervising the investigation of intricate claims.

Key Responsibilities:

  • Provide daily oversight of claims examiners and facilitate ongoing training related to claims adjustment and policy coverage.
  • Engage in the recruitment, selection, and training processes for new claims examiners.
  • Design and implement innovative programs aimed at enhancing the efficiency and workflow of claims examiners, while communicating these changes to both staff and management.
  • Contribute to departmental initiatives that focus on improving workflow and efficiency.
  • Evaluate information from adjusters, insured parties, contractors, and others to ascertain the company's financial obligations regarding property and liability claims.
  • Assist in the monthly assessment of open claims and the allocation of new claims to individual adjusters.
  • Participate in monthly claims meetings and discussions regarding lawsuit logs.
  • Review complaints filed with the Insurance Department and address written grievances from clients.
  • Maintain communication with adjusters, insured parties, and contractors to clarify inquiries and gather necessary information for coverage evaluation and loss determination.
  • Authorize claim payments within the manager's settlement authority by interpreting policy guidelines and adhering to company protocols.
  • Decline claims payments as per company standards and provide explanatory letters to the insured parties.
  • Oversee the investigation of complex claims and gather evidence to determine liability.
  • Facilitate negotiations and settlements of claims within the manager's authority when appropriate.
  • Manage litigation claims and coordinate with attorneys.
  • Collaborate with the Claims VP to enhance productivity among claims adjusters and examiners, and develop strategies for improving the claims department.
  • Review and verify claims examiner timesheets daily and approve time-off requests for direct reports.
  • Address work-related issues with individual staff members and determine corrective actions in line with company guidelines.
  • Ensure the security of the department at the end of the workday.
  • Perform any additional responsibilities as assigned by the supervisor.

Required Qualifications:

  • Bachelor's degree in a relevant field is mandatory.
  • A minimum of 4-5 years of supervisory or management experience in Homeowner Property Insurance is essential.
  • Proficiency in Xactware, Microsoft Office Suite, Microsoft Outlook, and Excel is required.
  • Demonstrated ability to review adjuster work products to ensure compliance with company standards.
  • Must possess the capability to obtain a Property and Casualty Adjusters license for all current and/or future states serviced by The Ladders.

Disclaimer: The responsibilities outlined above are intended to provide a general overview of the role. They are not exhaustive and may be subject to modification to meet the evolving needs of the company.

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