Casualty Claims Manager

Western Reserve Group•Wooster, OH

8d•$93,695 - $145,226•Hybrid

About The Position

The Casualty Claims Manager coaches and develops a team of 5-8 internal and external Claims Adjusters, Senior Claims Adjusters, and Claims Specialists responsible for the management, investigation, and resolution of claims, ensuring a high-quality work product, while continuously developing talent by assisting with the selection of top talent. The Casualty Claims Manager promotes a culture of claims customer service excellence where all are committed to providing differentiated customer experience. The Casualty Claims Manager will also ensure that staff properly manage an appropriate caseload of files in accordance with company standards and IC 27-4-1/ORC 3901-1-54. This position would be a hybrid position required to work from the office 3 days per week and remotely 2 days per week.

Requirements

Minimum of 5 years experience in Casualty or General Liability claims.
College Degree or Equivalent Experience.
5+ Years of Casualty or General Liability Claims experience gained through increasingly responsible position within the claims field.
Extensive experience in appropriate reserving procedures, effective negotiation skills in Personal, Commercial, General Liability, and Property coverage and settlement practices.
Excellent Written and Verbal Communication Skills.
Extensive experience in directing Independent Vendors and Coverage Counsel.
Superior Interpersonal Skills.
Efficient time management skills.
Excellent verbal and written communication skills. The individual must be able to effectively and clearly communicate with agents, insured’s, departmental and company personnel via telephone, fax, e-mail, one-on-one dialogue and small group presentations in a highly professional manner.
The position requires the individual to apply common sense, understanding, reasoning and sound educated judgement coupled with sound Claims training and experience to properly evaluate and analyze claims for recommended action within assigned authority levels.

Nice To Haves

AIC or CPCU designations highly preferred

Responsibilities

Leads and develops a team of Claims Adjusters, Senior Claims Adjusters, and Claims Specialists, ensuring the quality, accuracy, and timely resolution of claims that include high exposure/complex cases and litigation.
Proactively assists in selecting top talent, delivering continuous coaching, and rewarding and recognizing employees to reinforce behavior that ensure service excellence.
Assesses volume and nature of claims to be assigned and provides direction on losses to claim representatives as appropriate.
Direct involvement on select claims (significant exposure or complexity).
Review reserve amounts on high-cost claims and claims over the authority of the Claims Adjusters, Sr. Claim Adjusters and Claim Specialists.
Ensure effective communication with Underwriting, Agents, Insureds and Counsel.
Ensure compliance with all statutory and unfair claims practices act.
Monitors the work of team members to ensure reserves are adequately set and customer expectations are surpassed.
Conducts monthly audits of the claims process to include coverage analysis, investigation, valuation, scope, estimate, reserving, timeliness and the accurate disposition of claims. Provides feedback to the team for continuous improvement.
Analyzes any problematic trends and takes steps to avoid recurrence, appropriately escalating issues if needed.
Participate in monthly reviews of litigation and complex files with in-house counsel, VP Claim, AVP Claims and assigned Claims Adjusters/Specialists.
Promotes a culture committed to identifying process inefficiencies to continuously improve how work is performed.
Present complex cases to roundtable committee.
Attend and participate in mediations, pre-trials and trials.
Resolves customer complaints.
Promotes and advocates business unit goals and objectives, ensuring alignment with broader claims functional goals.
Organizes and conducts training of new employees.
Conduct performance evaluations and salary reviews of staff.
Maintains a regular diary system and reviews system reports to identify claims to review for quality and regulatory compliance.
Actively participates in or leads continuous improvement projects.
Stays current on industry trends and changes in insurance laws and regulations impacting claims handling.
Acts as a back-up for other unit Managers and adjusters while they are unavailable.
Performs various administrative activities, such as reviewing, preparing, and preparing follow-up letters to insureds regarding coverage, and attending agency meetings and functions.
Reviews claims on a regular basis checking for coverage, adequate reserves, accuracy and acts as a resource for answering claims questions. Provides additional services as required.
Works with SIU on fraudulent claims, and coordinates with Legal Department on litigated files.
Resolves coverage or unusual questions within designated authority. Conducts related research as necessary.
Continuously seek out and evaluate potential services or vendors that may increase efficiency, accuracy, or quality, or reduce expenses while maintaining quality customer service.
Makes recommendations to and participates with leadership in developing and evaluating claims procedures.
Provide recommendations and technical assistance on business system development, implementation and testing. Other special projects as needed.
Develops, analyzes, and reports metrics useful in measuring performance as well as effectiveness of the team operations.
Travel as needed relevant to position.