Self-Funded Claims Manager

Amwins•Tampa, FL

19d•Hybrid

About The Position

Amwins Self-Funded is seeking a Claims Manager to lead and support a claims team, strengthen day-to-day operations, and help provide high-quality service to clients and partners. The role leads team operations, supports employee performance and development, oversees claims documentation and filing, and provides guidance on complex and high-priority claims. It also supports claims reporting, operational process improvements, and effective relationships with internal departments and external partners. The position is primarily in-office, with the opportunity to work from home up to two days per week after completing training. The Claims Manager collaborates with the Director of Claims, Claims Lead, Claims Quality team, Claims Trainer(s), carriers, brokers and consultants, and administrators.

Requirements

At least 2 years of management experience.
Proficiency with Microsoft Office programs, including Excel, Outlook, SharePoint, and Teams.
Ability to manage time effectively, prioritize workload, and meet deadlines.
Strong teamwork skills and ability to work cooperatively and respectfully with staff and business partners.
Strong organizational and multitasking skills.
Ability to communicate clearly, professionally, and thoughtfully with internal and external partners.
Strong attention to detail and follow-through, with a demonstrated sense of urgency.
Supportive, solutions-oriented leadership approach and commitment to helping the team and business succeed.

Nice To Haves

Bachelor’s degree or 3–5+ years of experience working in Group Benefits.
3–5 years of claims or production-environment experience.

Responsibilities

Lead the day-to-day operations of assigned Claims team members and support the team’s success; responsibilities may include staffing recommendations, promotions, performance evaluations, and disciplinary actions, as applicable.
Support team member performance through regular feedback, accountability conversations, training, and technical coaching; partner with the assigned Claims Lead on targeted coaching and process guidance.
Partner with the Claims Quality team to use audit findings for team development, performance management, and operational oversight; review QA reports on a defined cadence and request additional audit coverage when appropriate.
Oversee the Claims Department’s master list of groups and cases, including contractual claims service parameters.
Manage client account assignments based on team and individual workload volume, when applicable.
Manage and oversee the Claims Department’s Stop Loss Claims filing process.
Provide oversight and support for complex or high-priority claim submissions and guidance on team submissions, correspondence, and processes.
Conduct claim reviews and handle reimbursement filing and reporting to Stop Loss carriers, when applicable or needed.
Manage and produce monthly claims reporting and notifications to Stop Loss carriers, when applicable or needed.
Support the development and implementation of policies, procedures, and process improvements for Claims operations.
Collaborate with the Director of Claims to support consistent, high-quality service delivery to clients.
Build collaborative relationships with internal departments and team members to support client service.
Build collaborative relationships with external partners, including carriers, brokers/consultants, and administrators.
Partner with Claims Trainer(s) to identify skill gaps, coordinate training programs, and support team member participation and development.
Perform other duties and projects as assigned.

Benefits

Medical, dental, and vision coverage available on the first day of employment.
Choice of medical plans through Blue Cross Blue Shield; Kaiser available for California employees.
Mental health support, including virtual therapy, digital coaching, and 24/7 EAP counseling.
Company-paid Basic Life and AD&D Insurance, Short-Term Disability, and Employee Assistance Program.
Health Savings Account with company contributions.
Health Care FSA, Dependent Care FSA, and commuter benefits.
Parental leave and adoption assistance.
Voluntary life insurance, critical illness, accident, and identity theft protection coverage.
Retiree medical benefits available for Medicare-eligible retirees.
401(k) with company match.
Generous paid time off and company holiday schedule.
Collaborative, continuing-education-focused work environment.
Career advancement opportunities.
Performance-based annual bonus program.