The Claims Manager coaches and develops a team of 5-8 internal and external Senior Claims Representatives and Claims Adjusters 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 Auto Physical Damage Claims Manager promotes a culture of claims customer service excellence where all are committed to providing a differentiated customer experience. The Auto Physical Damage Claims Manager will also ensure that staff properly manages an appropriate caseload of files in accordance with company standards and IC 27-4-1/ORC 3901-1-54.
Salary Grade (15) 93,695 - 119,460 - 145,226
Hybrid Role (3/2)
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
- Leads and develops a team of Commercial Claims Adjusters, Senior Claims Adjusters, and Claims Adjusters, 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 Sr. Claim Representative/ Claims Adjuster, and Commercial Adjuster.
- 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 reviews of complex files with in-house counsel as needed along with the, VP Claims, AVP Claims and assigned Adjuster.
- Promotes a culture committed to identifying process inefficiencies to continuously improve how work is performed.
- Present complex cases to roundtable committee.
- Proper reinsurance notification and trial alerts when required per procedures.
- Attend and participate in mediations, pre-trials and trials as needed.
- 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 (WRG Advantage). 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 7 - 10 direct reports
QUALIFICATIONSTo 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
10+ Years Casualty Claims Experience gained through increasingly responsible position within the claim field
Extensive experience in appropriate reserving procedures, effective negotiation skills, personal/commercial property coverage's and settlement practices.
Excellent Written and Verbal Communication Skills
Extensive experience in directing independents 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 Property 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.
