Job Description

Primary Responsibilities:

• Manage the claims activity for assigned state/client/claim type.
• Ensure adequate staffing to flex up/down within assigned area based on the claim volume.
• Ensure that all claims meet or exceeding client SLOs (Service level Objectives), including claims settlement, legal reviews and investigations as needed.
• Provide clear management direction to claims resources.
• Review, evaluate, and process claims to be sent to the client company for review and payment.
• Handle escalated phone calls with policyholders, agents, and carrier clients.
• Assign files to adjusters with attention to proper certification, licensing, skills, performance and zoning.
• Maintain per client documentation for claim guidelines, claim file guidelines, coverage guidelines by state/region, and claim specialist guidelines and training aids.
• Collaborate with Operations management and Client Relationship Managers to measure and improve file handling quality.  

• Assist with claims specialist hiring, interviewing, and other human resources functions.
• Conduct claim specialist formal mid-year and annual performance review process.    Provide coaching and development opportunities as prescribed in the performance reviews.
• Oversee claim specialist adherence to policies, practices, and guidelines (PTO, attendance, professional appearance, anti-discrimination, harassment, sexual harassment, etc) in the Employee Handbook.

QUALIFICATIONS

• Bachelor’s degree with business relevant degree or equivalent experience.
• Minimum of 5 year’s claims handling (commercial, property, auto, personal lines) and three years claims management experience.
• Innovative thinker and ability to implement new processes and procedures.
• Sound analytical abilities.
• Technical claims expertise.
• AIC or similar designations desired.
• Proficient with complex claims handling procedures and able to effectively train adjusters.
• Excellent customer service focus and customer relations skills.
• Strong teamwork skills.
• Proven record of developing and motivating employees.
• Ability to work non-traditional business hours and weekends as necessary.
• Experience of working in a client support role.
• Excellent written and spoken communication skills.
• Knowledgeable of field inspection concepts, practices, and procedures.
• Working knowledge of claim settlement practices as prescribed within the states that the examiner is supervising/reviewing claims.
• Maintenance of current and appropriate adjuster licensing in assigned states.
• Proficient in Xactimate /Sketch/Xactanalysis with an ability to train claim specialists on using the software.  
• Proficient in Microsoft Word, Excel, PowerPoint and Adobe Acrobat.
• Ability to travel a minimum of up 15% of the time. 

WORKING CONDITIONS

Working environments vary due to different assignments types, regions, and specific sites. Managers works from their home office or the assignment site offices. The home office would have limited exposure to harsh weather conditions, loud internal or external noise, fumes, or significant temperature changes. Overnight assignment site offices vary from permanent in-office hubs to converted temporary catastrophe claims offices.  At times, the temporary catastrophe claims office environment can be less than ideal with space shortages, power outages, loud noises, lodging shortages, and uncomfortable temperatures.  

PHYSICAL ACTIVITIES AND REQUIREMENTS

Work involves frequent sitting, computer usage, operating office equipment, cell phone usage, airline travel, driving, lifting and carrying 30-40 lbs., walking, face to face discussions, web based meeting participation. Willingness to work additional hours, as needed, including evening, overnight, weekend hours, and accommodates occasional meetings and work activities scheduled after normal hours. Ability to climb roofs, handle ladders, and inspection equipment, if necessary. Ability to assist a claim rep from the premises at the end of an assignment, if necessary.