Position Overview:
We are looking for an experienced Claims Manager to oversee and manage the claims process within our organization. In this role, you will be responsible for ensuring that all claims are handled efficiently, fairly, and in accordance with company policies and regulatory requirements.
Key Responsibilities:
- Review and evaluate claims to determine their validity and coordinate with relevant departments for resolution.
- Provide guidance to claims adjusters and support staff in assessing complex claims and making determinations.
- Manage the claims workflow, ensuring timely processing and ensuring that all claims are resolved within service level agreements.
- Establish and maintain strong relationships with clients, adjusting firms, and external stakeholders to facilitate the claims process.
- Conduct training and workshops for claims personnel to enhance their knowledge and skills in claims management.
- Analyze claims data and generate reports to identify trends, inefficiencies, and opportunities for improvement.
- Collaborate with legal and compliance teams to ensure claims processes adhere to relevant laws and regulations.
- Assist in the development and implementation of claims policies and procedures to improve operational efficiency.
- Handle escalated claims issues and provide resolutions in a timely manner.
- Participate in audits and assessments of the claims process to ensure compliance and best practices.
Requirements
- Bachelor's degree in Business Administration, Finance, Insurance, or a related field.
- Minimum of 5 years of experience in claims management, insurance, or related fields.
- Strong analytical skills with the ability to assess complex information and make sound decisions.
- Excellent communication, negotiation, and interpersonal skills to effectively manage relationships.
- Proficiency in claims management software and MS Office applications.
- In-depth knowledge of relevant regulations and compliance standards in the insurance industry.
- Ability to work independently, manage multiple tasks, and thrive under pressure.