Claims Manager
Required skills
- claims specialists
- customer correspondence
- coverage
- investigation
- loss valuation
- settlement
- carriers
- TPAs
- Program Executives
- Underwriters
Nice to have
- Loss Control
- Risk Analysis
Role summary
A Claims Manager is needed to oversee claims specialists, ensuring accurate claim evaluation and compliance with guidelines. This role involves managing the claims process for clients, including coverage, investigation, settlement, and communication with carriers and TPAs. Responsibilities include preparing detailed claim status narratives for executives, coordinating policy information requests, and managing external audits. The manager will also prepare loss reports, analyze claim trends, and field loss control questions, working with carriers and clients to set safety goals. Additionally, the role requires reviewing new loss notices, providing coverage verification, consulting on severe losses, and coordinating claim reviews. The Claims Manager will also speak at seminars and develop webinars on claims handling and trend mitigation, and ensure compliance with loss control recommendations. A Bachelor's degree or equivalent experience in insurance or a related field is required, along with strong commercial property/casualty claims handling knowledge, data analysis skills, and proficiency in Microsoft Office. Excellent communication, negotiation, organizational, and project management abilities are essential.
1. Claim Adjudication and Compliance
Manage claims specialists, ensuring proper evaluation of claims by guidelines.
Prepare correspondence to customer; claim approved or denied.
Work closely with clients through the claims process, providing assistance with coverage, investigation, loss valuation, settlement, and communication with carriers and TPA’s.
Prepare narrative for Program Executives, Underwriters, and other parties, as necessary, describing status of all our selected claims, routinely and upon request.
Route large loss notices and underwriting alerts to Underwriters and Program Executives
Coordinate requests for policy information from claims TPA and carriers.
Coordinate and manage external carrier insurance company audits.
2. Loss Control
Prepare quarterly premium and loss reports for specified programs, which may include getting loss reports out of carriers’ system and reviewing notes in carrier system.
Review, analyze and make recommendations on the overall claim trends for the book of business.
Prepare quarterly Stewardship report for specified programs.
Field loss control questions from clients or internally, work with carrier and client to establish annual loss control goals.
Partner with carriers to effectively manage on-line training courses and other safety material (on the website, in handouts, templates, checklists, etc.)
Review of new loss notices and carrier coverage position letters prior to issuance, provide insurance coverage verification, consult with client on large/severe losses and adjusters on large reserves/settlements or lawsuits.
Coordinate quarterly claim reviews with client and insurance company.
Speak at client seminars and develop webinars regarding claims handling, claim trends and discuss ways to reduce or mitigate claims.
Coordinate with carrier regarding the clients who should receive on site loss control visits and then review all safety reports from those visits and ensure compliance with any recommendations
Bachelor’s degree in insurance, business, finance, accounting, economics or related program or equivalent education and/or experience.
Strong understanding of commercial property/casualty claims handling
Ability to compile, analyze and interpret file information.
Ability to professionally interact with businesspersons of all levels and succinctly communicate information and strategies.
Proficient in Microsoft Office software.
Excellent verbal, written and interpersonal skills.
Customer Service Focused
Loss Control or Risk Analysis Experience preferred.
Ability to work independently and with minimal instruction and little direct oversight.
Demonstrated professional, tactful negotiation and persuasion skills to achieve objectives.
Organizational and time management skills to prioritize heavy workload to meet time sensitive deadlines.
Project management ability, analytical mindset, solution oriented, self-motivated, and likes to take initiative to find new and better ways of doing things.
Some travel required
This role is predominately based in our Overland Park office but is eligible for the company’s hybrid remote program.
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