Insurance Claims Manager

The Insurance Claims Manager is responsible for overseeing the entire process of evaluating and processing insurance claims. This role is crucial in ensuring that claims are processed accurately, efficiently, and in compliance with legal regulations, while also maintaining high standards of customer satisfaction. The Insurance Claims Manager plays a pivotal part in analyzing data and trends to optimize claims processing and improve operational strategies. The individual in this role will be required to liaise with various stakeholders including clients, insurance adjusters, and legal counsel regularly. Excellent analytical skills, coupled with a strong understanding of insurance policies and guidelines, are essential. The role demands strong leadership qualities to manage a team effectively and foster an environment of continuous improvement.

Responsibilities

• Oversee the evaluation, investigation, and approval of insurance claims.
• Ensure claims processing complies with company policies and regulatory requirements.
• Develop and implement strategies to streamline claims processing operations effectively.
• Manage and supervise a team of claims adjusters and support staff daily.
• Conduct regular audits of claims processes to ensure quality and accuracy.
• Collaborate with other departments to improve customer service and efficiency.
• Analyze claims data to identify trends and recommend operational adjustments.
• Offer training and guidance to team members to support their development.
• Resolve escalated customer complaints and complex claims issues efficiently.
• Prepare detailed reports and presentations for senior management on claims trends.
• Coordinate with legal counsel on claims requiring legal intervention or litigation.
• Maintain updated knowledge of insurance laws and regulations affecting claims management.

Requirements

• Bachelor's degree in insurance, finance, business administration, or related field.
• Minimum of five years of experience in insurance claims management roles.
• Proven ability to effectively lead and manage teams successfully.
• Strong analytical skills with a knack for problem-solving and decision making.
• Excellent communication skills, both written and verbal, are essential.
• In-depth knowledge of local and federal insurance regulations required.
• Proficiency in claims management software and Microsoft Office Suite applications.