DescriptionOverview:The Claims Manager is responsible for developing the company claim handling strategy and provides oversight of all claim processing and claim management activities. This position serves as the primary point of contact between the company and our customers, and provides guidance and support to ensure timely, accurate, and efficient claim processing.Responsibilities:
- Coordinate and oversee claim management strategies on reserving, settlement and resolution to bring claims to closure
- Develop and implement key performance indicators to monitor success of Workers' Compensation program
- Develop and or improve upon internal claims management procedures/processes to achieve KPIs
- Monitor and report on the effectiveness of the TPA performance
- Communicate and go on-site as necessary to locations to assist with all internal claim management activities
- Work with Safety and Transportation Safety teams to help identify and reduce adverse claim trends
- Coordinate and manage quarterly claim reviews with the TPA/carrier for managed claims
- Support the development of an internal active diary system of all WC claims that are being managed
- Coordinate internal claim updates as requested/required (i.e. internal claim reviews)
- Monitor claim reporting to TPA/carriers and report claims as required
- Develop and monitor goals for claim mitigation within locations
- Oversee return-to-work activity with internal and external partners
- Act as an internal resource for Workers' Compensation questions
- Utilize the TPA RMIS system for claim management and monitoring, or propose and implement an alternative system
Requirements:
- Business/Industry - Thorough understanding of insurance-related legal procedures, regulations and claims processing
- Data Analytics/Presentation - Ability to independently create data analytics report, interpret data, create presentations and conduct presentations/training to variety of stakeholders including company executives
- Administration and Management - Knowledge of business and management principles involved in strategic planning, resource allocation, and coordination of people and resources
Experience and Skills:
- 10+ years in a claims administration role, including 5+ years of experience as claims adjuster, examiner and/or supervisor with direct reports
- Bachelor's degree in business administration or related discipline
- 3-5 years of experience with both WC and Auto liability claim handling
- Experience reviewing and negotiating TPA contracts
- Transportation/warehousing experience preferred
- Excellent verbal and written communication and interpersonal skills
- Must be able to multi-task and work independently as well as contribute to the overall success of the team
- English and Spanish proficiency
Technology Skills:
- Experience implementing and managing RMIS systems
- Microsoft Office suite proficiency - Outlook, PowerPoint, Word, Excel, Teams, Microsoft Planner
- Video conferencing software proficiency - Microsoft Teams, Zoom
Work Environment:
- Ability to lift over 10 lbs. and stand and maintain active for long periods of time without reasonable accommodation
- Ability to travel onsite to various locations throughout the Northeast. Approximately 10-15% travel
- Ability to work extended hours as needed
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