The Casualty Claims Manager coaches and develops a team of 5-8 internal and external Claims Adjusters, Senior Claims Adjusters, and Claims Specialists responsible for the management, investigation, and resolution of claims, ensuring a high-quality work product, while continuously developing talent by assisting with the selection of top talent. The Casualty Claims Manager promotes a culture of claims customer service excellence where all are committed to providing differentiated customer experience.
The Casualty Claims Manager will also ensure that staff properly manage an appropriate caseload of files in accordance with company standards and IC 27-4-1/ORC 3901-1-54. This position would be a hybrid position required to work from the office 3 days per week and remotely 2 days per week.
Salary Grade (15) 93,695 - 119,460 - 145,226
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
- Leads and develops a team of Claims Adjusters, Senior Claims Adjusters, and Claims Specialists, ensuring the quality, accuracy, and timely resolution of claims that include high exposure/complex cases and litigation.
- Proactively assists in selecting top talent, delivering continuous coaching, and rewarding and recognizing employees to reinforce behavior that ensure service excellence.
- Assesses volume and nature of claims to be assigned and provides direction on losses to claim representatives as appropriate.
- Direct involvement on select claims (significant exposure or complexity).
- Review reserve amounts on high-cost claims and claims over the authority of the Claims Adjusters, Sr. Claim Adjusters and Claim Specialists.
- Ensure effective communication with Underwriting, Agents, Insureds and Counsel.
- Ensure compliance with all statutory and unfair claims practices act.
- Monitors the work of team members to ensure reserves are adequately set and customer expectations are surpassed.
- Conducts monthly audits of the claims process to include coverage analysis, investigation, valuation, scope, estimate, reserving, timeliness and the accurate disposition of claims. Provides feedback to the team for continuous improvement.
- Analyzes any problematic trends and takes steps to avoid recurrence, appropriately escalating issues if needed.
- Participate in monthly reviews of litigation and complex files with in-house counsel, VP Claim, AVP Claims and assigned Claims Adjusters/Specialists.
- Promotes a culture committed to identifying process inefficiencies to continuously improve how work is performed.
- Present complex cases to roundtable committee.
- Attend and participate in mediations, pre-trials and trials.
- Resolves customer complaints.
- Promotes and advocates business unit goals and objectives, ensuring alignment with broader claims functional goals.
- Organizes and conducts training of new employees.
- Conduct performance evaluations and salary reviews of staff.
- Maintains a regular diary system and reviews system reports to identify claims to review for quality and regulatory compliance.
- Actively participates in or leads continuous improvement projects
- Stays current on industry trends and changes in insurance laws and regulations impacting claims handling.
- Acts as a back-up for other unit Managers and adjusters while they are unavailable.
- Performs various administrative activities, such as reviewing, preparing, and running reports, preparing follow-up letters to insureds regarding coverage, and attending agency meetings and functions.
- Reviews claims on a regular basis checking for coverage, adequate reserves, accuracy and acts as a resource for answering claims questions. Provides additional services as required.
- Works with SIU on fraudulent claims, and coordinates with Legal Department on litigated files
- Resolves coverage or unusual questions within designated authority. Conducts related research as necessary.
- Continuously seek out and evaluate potential services or vendors that may increase efficiency, accuracy, or quality, or reduce expenses while maintaining quality customer service.
- Makes recommendations to and participates with leadership in developing and evaluating claims procedures.
- Provide recommendations and technical assistance on business system development, implementation and testing. Other special projects as needed.
- Develops, analyzes, and reports metrics useful in measuring performance as well as effectiveness of the team operations
- Travel as needed relevant to position.
SUPERVISORY RESPONSIBILITIESWill supervise 5 - 8 direct reports
QUALIFICATIONSQualified candidates would have a minimum of 5 years experience in Casualty or General Liability claims. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION and/or EXPERIENCECollege Degree or Equivalent Experience.
5+ Years of Casualty or General Liability Claims experience gained through increasingly responsible position within the claims field.
Extensive experience in appropriate reserving procedures, effective negotiation skills in Personal, Commercial, General Liability, and Property coverage and settlement practices.
Excellent Written and Verbal Communication Skills.
Extensive experience in directing Independent Vendors and Coverage Counsel.
Superior Interpersonal Skills.
Efficient time management skills.
LANGUAGE SKILLS Excellent verbal and written communication skills. The individual must be able to effectively and clearly communicate with agents, insured's, departmental and company personnel via telephone, fax, e-mail, one-on-one dialogue and small group presentations in a highly professional manner.
REASONING ABILITY The position requires the individual to apply common sense, understanding, reasoning and sound educated judgement coupled with sound Claims training and experience to properly evaluate and analyze claims for recommended action within assigned authority levels.
CERTIFICATES, LICENSES, REGISTRATIONS AIC or CPCU designations highly preferred
PHYSICAL DEMANDSThe physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Employees are required to sit at a work station to perform various PC functions. Additionally, the employee is required to devote substantial time to telephone communication.
While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee frequently is required to use hands to finger, handle, or feel. The employee is occasionally required to stand, walk, and reach with hands and arms.
Employees may be required to travel from time to time. This may require extended periods of time sitting in a vehicle.
WORK ENVIRONMENTThe work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The Casualty Manager is responsible for supervising claims staff to see that all WRG policies and philosophies are adhered to. The Property Manager will be assigned a specific work area. The work area will be located adjacent to other similar work areas. The work area has the necessary equipment to perform the position duties including personal computer, telephone, file space, and needed work table space.
The environment is reasonably quiet with needed interaction between other team members, immediate supervisor, and other company staff. Moderate noise level from telephone calls is expected.
