Claims Program Manager, Remote

Job Description

Since 2000, Crum & Forster's Accident & Health division (A&H) has offered a diverse portfolio of specialty insurance and reinsurance products nationwide. We place a strong focus on product development and creative distribution methods, along with excellent client service and support.

In addition to our robust domestic portfolio, which spans both special risk and medical solutions, A&H works on an international basis through various partnerships. Our global capabilities provide our partners with even broader flexibility in underwriting solutions. Gross premium written in 2025 surpassed $2.4B. The qualities and capabilities of Crum & Forster Accident & Health demonstrate our philosophy of building meaningful, long-term partnerships and our dedication to providing alternative strategies in an ever-changing insurance market.

The Claims department of the Crum & Forster Accident & Health segment is looking for a multi-talented individual to join the Program Claims team supporting the Specialty Business Unit (SBU). This Program Manager will work as part of the claims team to proactively manage a team of Specialists assigned to manage a portfolio of claim clients (Third Party Administrators and Managing General Underwriters) while performing oversight and enhancing the client relationship by identifying and resolving process issues in all phases of the client's and company's operations. This individual will interact internally with Underwriting, Actuarial, Compliance, IT, and externally with the division's business partners.

What you will do:

Relationship Management:

• Act as an Audit Coordinator, by scheduling, coordinating & monitoring annual audits
• Be the first-level review of all required reports drafted by Program Management Team members
• Have oversight of Program Team member functions including:
  • Assist in the creation of a relationship-based culture through a broad set of activities which include managing a diverse portfolio of products and administrators on an ongoing basis
  • Serve as a "next step" liaison to administrative, operations, and underwriting areas of the company, on an ongoing basis
  • Utilize sensitivity tactics to address relevant issues with distressed customers in a professional manner, on an ongoing basis
  • Participate in team member's meetings with clients and address all open issues no less often than monthly
  • Address technical issues and coordinate with IT team to seek resolutions as needed
  • Assign or assist with the Program Management Team's onboarding of new clients as needed
  • Establish long term customer relationships through prompt and courteous service

Risk Management

• Assist in Due Diligence of new program administration business, which includes onsite reviews and assessment, while providing Management an operational assessment of prospective partners
• Assist in annual reviews of administrators to ensure compliance with company requirements, while identifying gaps in process and/or areas for potential improvement at both the administrator and company level
• Monitor claims activity to identify any outliers, no less often than quarterly
• Identify processing, system and/or operational issues within client or company operations in order to ensure claims are paid consistent with policy terms

Reporting/Trend Analysis

• Prepare monthly reporting packages, including but not limited to, inventory reporting, first level (TPA customer service & turnaround) statistics, and referral analysis (turnaround times, volume breakdowns) for review by Senior Level Management
• On a monthly basis, provide an analysis of all claims related litigation/regulatory inquiries to identify all trends and exposure
• On no less than a quarterly basis, provide an analysis of all claims referrals logs to identify trends and recommendations for authority level adjustments as necessary

Legal/Regulatory

• Refer to and assist as necessary, all small claims litigation to the Legal team
• Review all attorney correspondences and coordinate responses with administrator
• Assist Compliance in reviews of claims-related regulatory inquiries

Best Practices/Process Documentation

• Draft initial documents for internal Claims Best Practices including:
  • Standards - both C&F and regulatory
  • Procedures
  • Workflow
• Review and update above practices, on no less than a quarterly basis
• Oversee the Program Management Teams review of TPA Best Practices, to ensure all Claims administrators are informed of and in adherence to applicable state unfair claims practices laws

Training & Development

• Continue development of product knowledge on the Program Management Team
• Assist in the development of Program Management Team to think bigger picture and outside the "claims audit box"
• Utilize actual situations (i.e. distressed administrators) as an educational and development tool for Program Management Team members
• Other duties as assigned

What YOU will bring to C&F:

• Proven ability to establish strong rapport with customers and team members.
• Demonstrated high level of service delivery, with a focus on customer satisfaction and issue resolution.
• Strong analytical and problem-solving skills, with the ability to identify and implement process improvements.
• Excellent attention to detail and organizational skills, with the ability to manage multiple tasks in a fast-paced environment.
• Ability to work independently and collaboratively within a team.
• Excellent communication skills, both written and verbal, with the ability to present complex information clearly.
• A commitment to personal accountability and continuous improvement.

Requirements:

• Bachelor's Degree from an accredited university/institution or equivalent experience
• 6+ years of relevant Special Risk, Travel, and Travel Medical experience
• Strong PC skills including Excel, Word, Outlook, Power Point
• Experience in specialty products such as Employer Stop Loss, Travel, Short Term Medical, Medical Travel, Workers Compensation and/or Occupational Accident is preferred
• Ability to Travel (20%)

What C&F will bring to you

• Competitive compensation package
• Generous 401K employer match
• Employee Stock Purchase plan with employer matching
• Generous Paid Time Off
• Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family's wellness, including your physical, mental and financial wellbeing
• A core C&F tenet is owning your career development, so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training to keep you progressing on your chosen path
• A dynamic, ambitious, fun and exciting work environment
• We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community

At C&F you will BELONG

#LI-AV1

#LI-Remote