Manager, Claims

Coverys, Inc.

$132K — $178K *
US-Anywhere
+ 7 other locationsRemote
Finance & Insurance
8 - 10 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree from a four-year college or university
  • 8 years of experience in medical malpractice or heavy bodily injury claims
  • Experience with insurance carriers is preferred
  • 3 years of supervisory or management experience
  • Broad knowledge of medicine and legal concepts in litigation
  • Familiarity with insurance policy contracts, especially in medical malpractice and general liability

Responsibilities

  • Analyze and verify insurance coverage for claims
  • Ensure timely and adequate reserves on claim files and approve adjustments
  • Assign claims to staff for disposition
  • Evaluate liability, damages and causation, and approve settlements
  • Advise leadership on claims status and attend committee meetings
  • Determine work procedures and manage workflow
  • Maintain and develop claims policies and procedures
  • Interact with other departments to coordinate services
  • Conduct audits of consultant case files for compliance
  • Identify and implement training needs for claims staff
  • Track and recommend improvements for the department
  • Manage staff performance evaluations and related issues
  • Assist in developing marketing strategies for claims

Benefits

  • Opportunities for professional development and further training
  • Supportive work environment with collaborative interaction between departments
  • Engagement in strategic planning processes for departmental improvement
  • Involvement in high-impact decision making regarding claims management
  • Potential for contribution to client retention and new business initiatives
Full Job Description

The Manager, Claims is responsible for all claims and litigation management activities for the claims professional staff. They will monitor the file handling and reserve setting by assigned staff as well as oversee and evaluate the work of defense counsel utilized by assigned staff for timely and cost effective case disposition.

Essential Duties & Responsibilities

  • Analyze and verify insurance coverage for claims brought against policyholders.

  • Assure timeliness and adequacy of reserves on claim files, approve or recommend adjustments as necessary.

  • Assign losses to claim staff for disposition of claims.

  • Evaluate liability, damages and causation and approves settlements (if appropriate) up to approved limit of authority.

  • Advise Claims leadership on claims status and attend Reserve & Settlement Committee Meetings as necessary.  Ensure timely reporting to the Reserve and Settlement Committee.

  • Determine work procedures, manage work schedules, and expedite work flow.

  • Maintain existing and develop new claims policies and procedures to improve the overall function of the department.

  • Interact with other departments as necessary to help facilitate and coordinate services to our insured and clients.

  • Conduct quarterly audits of consultant case files and ensure that file management guide protocols are current and reflective of proper claim handling practices

  • Monitor staff to identify and implement training needs and ensure compliance with the Company claims handling requirements.

  • Track and monitor results, recommend improvements and participate in departmental strategic planning. 

  • Manage assigned staff to include performance evaluations, time off, time card review, recognition and disciplinary issues.

  • May monitor trials as necessary.

  • As directed, assist Claims leadership in the development of claims related marketing strategies and tools for client retention and new business cultivation.

Education, Requirements & Competencies

  • Bachelor's degree (B. A.) from four-year college or university

  • 8 years’ experience in handling medical malpractice claims or heavy bodily injury claims

  • Experience working within an insurance carrier strongly preferred.

  • A minimum of 3 years of supervisory/management experience

  • Must have broad knowledge of medicine and familiarity with legal concepts and trends in litigation.  Must be knowledgeable in insurance policy contracts, particularly medical malpractice and general liability. 

  • Formal nursing and/or legal education is also a plus, but not required.

The base salary range for this role is $132,300 - $178,900. Individual compensation packages are based on a variety of factors that are unique to each candidate including geographic location, skill set, experience, qualifications and education.

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