claims manager

Clark Construction

<div><div><div>Job Description
</div></div><div><div><div><div><div><div><div><div><div>Clark Construction Group is a leader in the construction industry, shaping America's skyline for over a century.
The Risk Management Team is a critical, strategic function tasked with protecting the enterprise from catastrophic financial loss while providing cost-effective risk management and insurance solutions that mitigate operational risk, contribute to competitive advantage, and enhance profitability. This team is comprised of finance, operations, contract, and risk professionals.
Essential Duties and Responsibilities:
The Claims Manager will establish, manage, and execute the financial strategy and core risk management program elements for the department.
I. Risk Program Administration &amp; Strategy
<ul><li>Oversee the financial administration of the company&rsquo;s captive insurance programs, including financial administration and regulatory compliance.
</li><li>Apply broad knowledge of Property &amp; Casualty (P&amp;C) insurance to evaluate coverage specifications and assist in negotiations with insurers.
</li><li>Manage the financial lifecycle of Contractor Controlled Insurance Programs (CCIP), including enrollment tracking, payroll reporting, and premium allocations.
</li><li>Oversee the Subcontractor Default Insurance (SDI) program, focusing on financial risk assessment of subcontractors and program administration.
</li><li>Provide recommendations for alternative risk financing and risk management solutions to enhance profitability.
</li><li>Maintain the Risk Management Information System (RMIS) to track insurance schedules and claim activity costs.
</li></ul>II. Project &amp; Pursuit Support
<ul><li>Interact with Legal counsel to identify risks within proposed construction agreements.
</li><li>Interface with lenders, joint venture partners, and project owners to ensure insurance and financial requirements are met.
</li><li>Assist Project Teams in implementing insurance budgets and accounting procedures for all newly acquired projects.
</li></ul>III. Leadership and Management
<ul><li>Manage direct reports within the Risk Management team.
</li><li>Work collaboratively with the various business groups throughout the organization.
</li><li>Drive the development of innovative risk solutions that improve the firm&rsquo;s financial resilience and operational efficiency.
</li><li>Interface effectively with project teams, business partners (Insurers, Brokers, TPAs, Actuaries, Captive Managers, etc.), and others to develop and implement risk management processes and solutions.
</li></ul>Skills and Qualifications:
Education and Experience
<ul><li>8+ years of professional claims management in the P&amp;C industry. Background in risk management, insurance, real estate or construction is preferred but not required.
</li><li>Required: Bachelor&rsquo;s Degree (Risk Management, Finance, or related field preferred).
</li><li>Foundational knowledge of P&amp;C insurance and risk financing; professional designations such as CPCU, ARM, or CRIS are a plus..
</li><li>Experience managing others is highly valued.
</li></ul>Core Competencies
<ul><li>Superior interpersonal skills: Ease in working with people up and down the organization hierarchy, demonstrated ability to interact with senior executives, and naturally adaptive to different audiences.
</li><li>Strong project management skills, results-driven, adaptable with ability to manage multiple priorities and meet deadlines.
</li><li>Ability to analyze complex problems involving varying viewpoints and to develop viable solutions.
</li><li>Excellent written and verbal communication skills.
</li><li>Ability to take initiative, be proactive and work efficiently without supervision.
</li></ul>A Drug Free Workplace: Clark promotes a drug free workplace. A pre-employment drug &ldquo;fitness for duty&rdquo; screening is required, and the company conducts random quarterly drug &ldquo;fitness for duty&rdquo; tests.</div></div></div></div></div></div></div></div></div></div>

Claims Manager

Reserv

<div>About Reserv
Reserv is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims. Founded by insurtech veterans with deep experience in SaaS and digital claims, Reserv is venture-backed by Bain Capital and Altai Ventures and began operations in May 2022. We are focused on automating highly manual tasks to tackle long-standing problems in claims and set a new standard for TPAs, insurance technology providers, and adjusters alike.
We have ambitious (but attainable!) goals and need people who can work in an evolving environment. If building a leading TPA and the prospect of tackling the long-standing challenges of the claims role sounds exciting, we can&rsquo;t wait to meet you. 
About the role<ul><li>
As a Claims Manager at Reserv, you will be a working leader providing support to a Claims Director with leadership and claim technical responsibilities. Leadership responsibilities will include overseeing work done within the Real Property Appraisal staff. We want your background and experience to deliver operational effectiveness, particularly in leveraging technology and analytics to drive better efficiencies and performance. You will serve a critical role with the team, the customers, and the client. This role will balance management responsibilities and individual contributor responsibilities when volume dictates the need for assistance with a claim.</li></ul>
Who you are<ul><li>
Highly motivated and growth-oriented, impactful and influential</li><li>
Claims professional - you are knowledgeable and have a track record of success in commercial auto claims adjudication.</li><li>
Strong leader - through formal management experience or a proven track record of peer and project leadership, you have demonstrated the ability to motivate, support, and teach a team to help them excel in their roles.</li><li>
Tech-oriented - You are excited by the prospect of building a tech-driven claims organization while delivering an excellent service and have proven results leveraging technology and analytics.</li><li>
Passionate - Claims professional who cares about their team, the customer, and their experience</li><li>
Empathetic leader - You exercise empathy and patience towards everyone you interact with</li><li>
Sense of urgency - at all times. That does not mean working at all hours</li><li>
Creative - You challenge existing assumptions and find ways of leveraging technology and the talents of your team to address problems</li><li>
Curious - You want to know the whole story so you can make the right decisions early and be decisive when it counts.</li><li>
Problem solver - You have the ability to take a &lsquo;deep dive&rsquo; into the details of the business while staying focused on the big picture.</li><li>
Anti-status quo - You don&rsquo;t just wish things were done differently; you act on it</li><li>
Communicative - You are comfortable with and understand the importance of phone communications throughout the claims process.</li><li>
And did we mention a sense of humor? Claims are hard enough as it is!</li></ul>
What we need
We need you to do all the things typical to the role:<ul><li>
Flexibility - you will need to be able to switch from claims handling to coaching and feedback</li><li>
Agility- you must have an agile mindset and the ability to pivot from focus to focus in a moment&rsquo;s notice</li><li>
Be consistently dependable in achieving or exceeding goals and overcoming obstacles</li><li>
Implement and maintain best practices for claims handling, including claim intake, investigation, evaluation, settlement, and recovery</li><li>
Align team with client and customer expectations of the claims process</li><li>
Serve as a resource for escalated claims</li><li>
Foster a positive work environment, promote teamwork, and encourage professional growth and development</li><li>
Attract, hire, retain, and provide a high level of training with the support of the rest of the leadership team</li><li>
Prepare and present comprehensive claims reports, metrics, and analyses to clients and customers; advise clients on claim trends and loss mitigation</li></ul>
Job Duties:<ul><li>
Responsible for having direct reports</li><li>
Responsible for initial onboarding tasks / access and new hire cultural immersion</li><li>
SME for first-line questions, escalations, roundtable discussions</li><li>
Increased reserve and payment authority with the ability to assist with moderate reviews</li><li>
Identify topics and trends to discuss in team Huddles and Elevated Claims Experience Workshops lead/ co-lead by Team Leads, Managers, and other Reserv employees</li><li>
Customer Obsession Champions - Active advocates who help leadership cultivate a customer-centric mindset</li></ul>
Requirements<ul><li>
10+ years of insurance claims experience, real property damage claims; preference for property damage appraisal experience in programs such as Xactimate and Symbility</li><li>
5+ years of leadership experience with a preference for experience managing in a remote environment</li><li>
Comfortable with technology and the ability to evolve the claims systems and processes to drive better efficiencies and outcomes</li><li>
Demonstrated commitment to quality, accuracy, and attention to detail</li><li>
Integrity, ethics, and a strong sense of accountability in handling confidential and sensitive information</li><li>
Active adjuster license required: resident state license if available, otherwise a Designated Home State (DHS) license</li></ul> 
Benefits<ul><li>
Generous health-insurance package with nationwide coverage, vision, &amp; dental</li><li>
401(k) retirement plan with employer matching</li><li>
Competitive PTO policy &ndash; we want our employees fresh, healthy, happy, and energized!</li><li>
Generous family leave policy after 8 months of continuous work</li><li>
Work from anywhere to facilitate your work life balance</li><li>
Apple laptop, large second monitor, and other quality-of-life equipment you may want. Technology is something that should make your life easier, not harder!</li></ul> 
Additionally, we will<ul><li>
Listen to your feedback to enhance and improve upon the long-standing challenges of an adjuster and the claims role</li><li>
Work toward reducing and eliminating all the administrative work from an adjuster role</li><li>
Foster a culture of empathy, transparency, and empowerment in a remote-first environment</li></ul> 
At Reserv, we value diversity in backgrounds, perspectives, and life experiences and believe that diversity in viewpoints and critical thinking drives innovation, first-principles thinking, and success. We welcome applicants from all backgrounds and encourage those from all walks of life to apply. If you believe you are a good fit for this role, we would love to hear from you!</div>

Claims Manager, Property Damage

Sedgwick

<div>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there&rsquo;s no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
Certified as a Great Place to Work&reg;
Fortune Best Workplaces in Financial Services &amp; Insurance
Claims Manager, Auto | Bodily Injury &amp; Property Damage
PRIMARY PURPOSE: To manage the technical and operational functions within assigned office(s) including compliance with company standards and industry best practices; to ensure consistent delivery of quality services; to be responsible for staffing and training needs; and to be responsible for budget preparation and profit and loss management. Has direct responsibility for 25-49 colleagues.
ESSENTIAL RESPONSIBLITIES MAY INCLUDE
<ul><li>Responsible for overall operational management for assigned locations/offices.
</li><li>Establishes policy and procedure to assure compliance to best practices, claims management services standards, state regulations and client service requirements.
</li><li>Establishes business plan with goal and objectives for the partnership and assigned locations/offices.
</li><li>Monitors management reports relating to the partnership/office performance.
</li><li>Assists with the coordination of sales and client service efforts.
</li><li>Travels as required.
</li><li>Administers company personnel policies in all areas and follows company staffing standards and training recommendations.
</li><li>Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.
</li><li>Provides support, guidance, leadership and motivation to promote maximum performance.
</li></ul>QUALIFICATIONS
Education &amp; Licensing: Eight (8) years claims management experience including two (2) years supervisory experience or equivalent combination of experience and education.
<ul><li>Baccalaureate degree from an accredited college or university preferred. Licenses as required.
</li><li>Skills: excellent oral and written communication, including presentation skills, PC literate, including Microsoft Office products, and leadership/management/motivational skills
</li></ul>Work environment requirements include &ndash;
 
Physical: Computer keyboarding
 
Auditory/visual: Hearing, vision and talking
 
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $105,000 . A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
<h2 class="jobSectionHeader">If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.</h2></div>

Claims Manager, Auto | Bodily Injury & Property Damage

Rainbow Restoration UK

<div>Rainbow Restoration of Buffalo &ndash; 190 Gruner Road, Buffalo, NY 14227
$40,000 - $60,000 annual salary 
Position Summary
Rainbow Restoration of Buffalo is seeking an organized, customer-focused Claims Manager to join our growing team. This position serves as the primary point of contact for property owners, insurance adjusters, project managers, subcontractors, and internal team members throughout the restoration process.
The Claims Manager is responsible for accurately estimating residential and commercial mitigation and reconstruction projects while ensuring projects move efficiently from initial loss through final approval and completion. This role requires exceptional communication, organization, project management, and customer service skills.
If you thrive in a fast-paced environment, enjoy solving problems, and are committed to providing outstanding service during difficult situations, we'd like to hear from you.
Primary Responsibilities<ul><li>
Prepare detailed and accurate estimates in Xactimate and Symbility for:</li><li>
Residential water, fire, mold, storm, and other mitigation projects</li><li>
Residential reconstruction projects</li><li>
Commercial mitigation projects</li><li>
Commercial reconstruction projects</li><li>
Review scopes of work and ensure estimates accurately reflect project requirements.</li><li>
Communicate with insurance adjusters to obtain estimate approvals and resolve scope differences.</li><li>
Meet with homeowners, commercial property owners, facility managers, and property management companies to explain the restoration process and answer questions.</li><li>
Coordinate with Operations to ensure project scopes, scheduling, and production align with approved estimates.</li><li>
Work closely with Business Development to ensure seamless customer service and relationship management.</li><li>
Coordinate with subcontractors regarding project scope, scheduling, pricing, and change orders.</li><li>
Track estimate revisions, supplements, approvals, and documentation throughout each project.</li><li>
Maintain organized electronic job files and documentation.</li><li>
Monitor project progress and assist in resolving issues that could delay completion or payment.</li><li>
Ensure all estimating and claim documentation complies with company standards and insurance carrier requirements.</li><li>
Assist in collecting required documentation to support supplements and final billing.</li><li>
Maintain professional relationships with customers, insurance professionals, and referral partners.</li><li>
Represent Rainbow Restoration with professionalism, integrity, and exceptional customer service.</li></ul>
Qualifications<ul><li>
Experience writing estimates using Xactimate (preferred).</li><li>
Experience in restoration, construction, insurance claims, or property damage repair.</li><li>
Strong understanding of residential and commercial construction methods.</li><li>
Excellent written and verbal communication skills.</li><li>
Outstanding customer service skills.</li><li>
Strong project management and organizational abilities.</li><li>
Ability to prioritize multiple projects in a fast-paced environment.</li><li>
High attention to detail and accuracy.</li><li>
Ability to work independently while collaborating with multiple departments.</li><li>
Valid driver's license with a clean driving record.</li></ul>
Preferred Experience<ul><li>
3+ years of restoration, insurance adjusting, or construction estimating experience.</li><li>
Knowledge of water mitigation, fire restoration, mold remediation, and reconstruction.</li><li>
Experience working with insurance carriers and third-party administrators.</li><li>
Familiarity with restoration industry software including Xactimate, DASH, Mitigate, CompanyCam, or similar platforms.</li></ul>
Compensation &amp; Benefits
Salary: $50,000&ndash;$65,000 annually, based on experience and qualifications.
Benefits Include:<ul><li>
Health Insurance</li><li>
Dental Insurance</li><li>
Vision Insurance</li><li>
Paid Time Off</li><li>
Paid Holidays</li><li>
401(k) with company match</li><li>
Company-paid life insurance</li><li>
Professional development and training opportunities</li></ul>
Why Join Rainbow Restoration?
At Rainbow Restoration, we help families and businesses recover after unexpected property damage. Our team is committed to delivering exceptional customer service, quality workmanship, and clear communication from the first phone call through project completion. We believe in doing the right thing, supporting one another, and creating an environment where employees can grow professionally while making a meaningful difference in the lives of our customers.
If you're looking for a career where your expertise, leadership, and communication skills make a real impact every day, we'd love to meet you.</div>

Restoration Claims & Estimate Manager

Tango

<div>tango is a leader in the home health management industry and is preparing for significant growth! Our mission is to deliver innovative, home-based, post-acute solutions through proprietary technology and proven processes. We partner with health plans to provide a comprehensive suite of products and services designed to manage the total cost of care. 


We are currently looking for a Claims Manager to join our growing team! 


The Claims Manager provides tactical, technical leadership for claims operations with a focus on issue resolution, process improvement, auditing, and cross-functional support. This role is specialized in technical troubleshooting, claims reconciliation, batch processing, and collaboration with internal partners to ensure the smooth operation of claims workflows. 


Office Location: 

<ul><li>
2415 E Camelback Road, Suite 700, Phoenix, AZ 85016</li><li>
Remote</li></ul> 


Responsibilities and Duties: 


Responsibilities include, but are not limited to the following: 

<ul><li>
Serve as technical lead for problem-solving claims issues; troubleshoot and resolve issues during operational disruptions.</li><li>
Oversee batch assignments, batch-closure operations, adjudication runs and claims reconciliation processes.
</li><li>Execute audit and universe review protocols; ensure data integrity and accuracy across all claims transactions.</li><li>
Oversees the 277CA process</li><li>
Oversee performance of systemic tools (Symkey, AMP$, EDIWORKS, SDS or other applicable tools) to ensure transparency, capability alignment, and long-term sustainability, enabling the team to operate efficiently and effectively
</li><li>Ensure SFTP process reliability for claims file transfers; monitor all inbound and outbound jobs and alert to transmission failures.</li><li>
Manage and remediate clearinghouse rejections; coordinate correction cycles with vendors and internal teams.</li><li>
Collaborate with QA and team members to identify, test, and implement new business rules to improve adjudication rates and minimize claim errors.</li><li>
Partner with Provider Contracting, Networks, and Accounting teams to resolve fee schedule, network setup, and payment processing issues.</li><li>
Collaborate with Eligibility and Authorization teams to resolve member-related issues impacting claims processing.</li><li>
Maintain comprehensive documentation of all processes, issue resolutions, and system updates.</li><li>
Recommend and implement process improvements based on operational analysis and performance metrics.</li></ul> 


Qualifications: 

<ul><li>
Bachelor's degree or equivalent technical experience</li><li>
5+ years in healthcare claims operations, with expertise in workflow optimization and technical troubleshooting</li><li>
Strong knowledge of claims adjudication, batch processing, EDI/clearinghouse operations, and accounting reconciliation</li><li>
Advanced understanding of SFTP/file transfer protocols and claims system architecture</li><li>
Proficiency with claims platforms, data analysis, and SQL or similar query tools preferred</li><li>
Excellent analytical, organizational, and cross-functional communication skills</li><li>
Ability to manage multiple complex issues and prioritize effectively in a fast-paced environment</li></ul> 


Proven Personal Attributes: 

<ul><li>
Technical problem-solver with strong analytical and troubleshooting capabilities</li><li>
Proactive and detail-oriented with commitment to accuracy and process integrity</li><li>
Strong collaboration skills with ability to partner across departments and teams</li><li>
Initiative-driven with focus on continuous improvement and operational efficiency</li><li>
Reliable and accountable with strong work ethic and deadline commitment</li><li>
Self-motivated learner with ability to stay current on system and regulatory changes</li><li>
Composed and professional under pressure with strong decision-making abilities</li></ul> 


tango provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. tango will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship.</div>

Manager, Claims

PharMerica

<div>Our Company:
<div>
PharMerica</div><div></div>
Overview:<div></div><div> 
PharMerica, a part of Brightspring Health Services, is a long‑term care pharmacy services provider that supplies medications, clinical support, and pharmacy management to healthcare organizations across the United States.</div><div>
</div><div>
The Claims Supervisor manages associates' assignments and work queues on a daily and weekly basis, ensuring the timely resolution of claims, accurate billing, and the effective distribution of work to support operational efficiency.</div><div>
</div><div>
This is a remote opportunity. Applicants can live anywhere within the Continental USA.</div><div>
Night Shift Schedule: 10:00pm to 6:30am eastern. Must be able to work eastern time zone hours.</div><div>
</div><div>
The ideal candidate will have 3+ years direct supervisory experience along with 3rd party billing/collections experience. 
</div><div>
REQUIRED: Long-Term Care adjudication experience</div><div></div><div><div> 
Benefits and perks for You!</div><ul><li>
Medical, Dental, Vision insurance</li><li>
Health Savings &amp; Flexible Spending Accounts (up to $5,000 for childcare)</li><li>
Tuition discounts &amp; reimbursement</li><li>
401(k)</li><li>
Company Paid Time Off*
</li><li>Shift Differential</li><li>
DailyPay</li><li>
Pet Insurance</li><li>
Employee wellness and discount programs</li></ul></div> 
<div></div>
Responsibilities:
<ul><li>Works in conjunction with the 3rd Party Claims Manager to establish specific associate goals, department wide goals, performance tracking and quality assessment audits.</li><li>Establish and maintain professional and effective relationship with staff, peers, payers and other stakeholders.</li><li>Provides associates assignments and work queues on a daily and/or weekly basis. Including resolution, billing, and appropriate distribution of work.</li><li>Monitors quality of work performed by all associates, including interaction and compliance.</li><li>Holds regularly scheduled meetings with staff to discuss performance metrics and ensure employees are on track to meet their goals.</li><li>Report to Manager any trends occurring with payers and/or processes</li><li>Updates staff with communications and process changes as directed by 3rd Party Claims Manager, Director or Senior Management and insures compliance.</li><li>Handles escalated calls from customers and payers to ensure proper resolution.</li><li>Mentor and provide oversight of Team Leads and Associate II staff to insure they are adequately communicating staff training needs, shadowing staff when assigned, performing monthly quality assessment reviews, and taking a lead role in any special projects that may be assigned by Supervisor or Manager.</li><li>Manages staff attendance and time sheets for payroll (Kronos) system. Assures staff is meeting attendance policies and reports any variations to Manager.</li><li>In conjunction with feedback provided by Team Lead and/or Associate, monitor work performance including quality</li><li>Ensure assignments are fair and balanced based on Team Lead/Associate level skills sets.</li><li>Works to update, create and/or maintain Standard Operations Procedures for the department.</li><li>Ensures Sarbanes Oxley (SOX) compliance on all variance, write-off and convert exception reports inclusive of adequate signatures are obtained.</li><li>Proper storage of completed documents per Compliance policies.</li><li>Performs other tasks as assigned.</li><li>Conducts job responsibilities in accordance with the standards set out in the Company&rsquo;s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.</li><li>Works to update, create and/or maintain Standard Operations Procedures for the department.</li></ul>
Qualifications:
<div>
Education/Learning Experience 
<ul><li>Required: Associates degree, 4 year college , technical degree or 4+ years equivalent experience</li></ul>
Work Experience 
<ul><li>Required: 3+ years direct supervisory experience</li><li>Desired: 3rd Party Billing or collections/billing experience in the healthcare industry, AS400 computer systems experience or Pharmacy Technician.</li></ul>
Skills/Knowledge 
<ul><li>Required: Proficiency in MS Office Products (Excel, Word) and Basic computer knowledge</li><li>Required: Ability to maintain confidentiality</li><li>Desired: AS400 Computer Systems Experience</li></ul>
Behavior Competencies 
<ul><li>Required: Excellent communication skills, both written and oral</li><li>Required: Problem solving and detail oriented</li><li>Required: Strong time management, organizational skills and self-starter</li><li>Required: Strong attendance and leadership</li></ul></div>
About our Line of Business: PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.</div>

Claims Processing Supervisor

Arbella Insurance

<div>Under limited direction, lead the investigation and timely disposition of first and third party claims. These claims may require a high level of technical experience and may involve large damages and/or questions of coverage. Oversee team performance and production to ensure Claim department goals are achieved in support of the business plan. Responsible for execution of tactical, day-to-day activities and imparting functional technical expertise.
Key Responsibilities<ul><li>
Select, train and develop an effective and efficient staff</li><li>
Establish and communicate clear performance standards and objectives
</li><li>Conduct performance evaluations; recommend salary adjustments, promotions, transfers, and dismissals</li><li>
Counsel employees on educational and job opportunities which will enhance their career development
</li><li>Spend time coaching, mentoring, training, and developing their staff, addressing other responsibilities that need to be done at this level, and an appropriate work-life balance has been achieved</li><li>
Ensure exceptional customer service and high quality work is delivered from direct reports</li><li>
Monitor operations and staff and recommend, when necessary, changes in methods, procedures, structure and additions or changes in personnel to secure optimum utilization of resources</li><li>
Keep staff informed of current problems, changes and new developments in the department and company by conducting periodic meeting</li><li>
Administer all policies and procedures contained in the Arbella Employee Handbook; communicate to staff, interpret as necessary, and ensure compliance</li><li>
Monitor reports on productivity trends; recommend and implement changes on an ongoing basis to improve productivity
</li><li>Compile and analyze data and create reports to provide information to management</li><li>
Operate, input and retrieve information using the automated claim system; request checks, form letters and other correspondence through the automated claim system</li><li>
Analyze claim files, write directives concerning the files and assign or reassign files to claim representatives</li><li>
Review files on a periodic basis to determine accuracy and completeness and, if required, issue directives for further investigation, evaluation, negotiations and/or contact with legal channels</li><li>
Monitor the accuracy, completeness, and the appropriateness of billings (e.g. legal, medical, appraisal) when reviewing claim files</li><li>
Review reserve recommendations, establish reserves and make recommendations on reserves exceeding authority</li><li>
Provide the necessary guidance to unit personnel on investigations, appraisals of damages, liability, coverage and settlement techniques</li><li>
Assist in establishing Claim Office objectives supportive of the Claim Department business objectives</li><li>
Assist in the selection and evaluation of defense attorneys, medical examiners and independent adjusters</li><li>
Review and assist in preparing suit cases for forwarding to legal counsel, checking to assure that coverage is not exceeded, that legal reserves are adequate and confer with attorneys about these matters</li><li>
Service new larger risks and agents within Claim Office territory</li><li>
Organize workflows of the automated claim system to provide maximum productivity</li><li>
Assist in the training of new Claims Technical Team Managers</li><li>
Control expenses to meet the Claim Office budget and keep expenditures to a minimum</li><li>
Extend settlement authority as warranted and/or investigate and settle difficult cases as required or requested to assure proper investigation and disposition of all cases</li><li>
Attend trials, no-fault medical arbitration, and inter-company arbitration hearings, if requested</li><li>
Assist in the training of staff in the operation and uses of the automated claim system</li><li>
Monitor workplace and work practices to ensure safe office conditions, and make recommendations and/or changes as necessary</li><li>
Keep Manager informed verbally and in writing of activities and problems within assigned area of responsibility; refer matters beyond limits of authority and expertise to Manager for direction</li><li>
Perform other related work as required or requested</li></ul>
Requirements
<div><ul><li>Consistently achieves all key performance indicators in support of business plan while successfully demonstrating Manager level competencies</li><li>
Attract, develop and retain top talent including leveraging individual development efforts and succession planning</li><li>
Demonstrates the ability to proactively identify strategic opportunities and develops, implements and drives identified solutions</li><li>
Effectively manage within established budget</li><li>
Create and lead a high-performing, engaging team</li><li>
Progressive claim work experience, some work experience in Bodily Injury preferred</li><li>
Excellent communication, customer service and leadership skills.</li></ul>
Our current reasonable and good faith estimate of the annual salary or hourly wage range for this position is approximately $90,000 - $130,000 based on a variety of factors including, but not limited to, relevant skills and experience, educational background and certifications, performance and qualifications, market demand for the role and other organizational needs.
#LI-CL1
Please note: The advertised pay range is not a guarantee or promise of a specific wage.</div></div>

Team Manager - Claims - Bridgewater Office

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