Overview: The Claims Manager monitors and assures the quality and efficiency of claim department operations with the overall objective of providing courteous, accurate and timely claims service. The position requires leadership ability, strong technical knowledge of LTCI claims practices and procedures, excellent organizational skills, diplomacy and tact.

Job Duties

1. Oversee the activities of Claims Supervisors.
2. Monitor claim department workflow and volume. Collaborate with Supervisors to:

• Adjust work assignments to assure timely claim handling
• Monitor for regulatory compliance
• Verify that contestable claims receive appropriate investigation
• Interview job applicants with supervisors and make hiring recommendations.
• Through the review of management production reports, customer service reports, internal audits and in consultation with claims supervisory staff, measure and grade individual claims employee performance.
• Consult with Supervisors as they plan employee performance evaluations. Participate in administering performance evaluations and determining merit increases and promotions.
• Coach Supervisors to foster an atmosphere of open communication, to model professional behavior, and to require goal achievement within their teams.
• Train and oversee Supervisors in the documentation of substandard performance and the development of employee performance improvement plans. Support Supervisors in the administration of progressive discipline when necessary.
• Consult and advise Claim AVP on technical matters and matters of departmental practices and procedures.
• Advise the Claim AVP periodically on the performance and cost-effectiveness of vendors.
• Foster good relations with client company personnel and reinsurance company personnel and direct communication as needed on claims matters.
• Performs any other duties as directed by the Director of Claims and/or the VP of Claims.

Prerequisites for the Job

• Minimum 10 years’ increasingly complex claims adjusting/handling experience with preferred experience in LTC, Life or Health insurance. Proficiency in oral and written English language communication
• Willingness to work cooperatively with others
• Detail-oriented
• Able to manage multiple tasks and projects under time constraints
• Previous experience using email, Internet, Windows and Microsoft Office and other applicable computer systems
• Well organized
• Bachelor of Arts or Bachelor of Science degree preferred. Alternatively, the applicant can possess comparable experience in lieu of education in the form of developed analytical skills, technical reading skills and report writing with a High School diploma or GED.
• High school diploma or GED, 2 year college degree preferred
• Physical and mental requirements for Managerial personnel

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