Claims Program Manager, Remote

Crum & Forster • Eatontown, NJ

13h • $61,600 - $115,700 • Remote

About The Position

Crum & Forster’s Accident & Health Claims department is seeking a Claims Program Manager to support the Specialty Business Unit. The role is part of the claims team and proactively manages a team of Specialists overseeing a portfolio of claim clients, including Third Party Administrators (TPAs) and Managing General Underwriters (MGUs). The manager provides operational oversight, strengthens client relationships, identifies and resolves process issues, and coordinates with internal partners including Underwriting, Actuarial, Compliance, and IT, as well as external business partners.

The position oversees client relationships, program risk management, reporting and trend analysis, legal and regulatory coordination, claims best-practice documentation, and team training and development. It includes coordinating annual audits, reviewing reports, monitoring claims activity, evaluating administrators, preparing recurring management reporting, and supporting process improvements. The role is remote and requires the ability to travel 20%.

Requirements

• Bachelor’s degree from an accredited university or institution, or equivalent experience.
• At least 6 years of relevant Special Risk, Travel, and Travel Medical experience.
• Strong PC skills, including Excel, Word, Outlook, and PowerPoint.
• Ability to travel 20%.
• Ability to establish strong rapport with customers and team members.
• Demonstrated high level of service delivery, with a focus on customer satisfaction and issue resolution.
• Strong analytical and problem-solving skills, including the ability to identify and implement process improvements.
• Excellent attention to detail and organizational skills, with the ability to manage multiple tasks in a fast-paced environment.
• Ability to work independently and collaboratively within a team.
• Excellent written and verbal communication skills, including the ability to present complex information clearly.
• Commitment to personal accountability and continuous improvement.

Nice To Haves

• Experience in specialty products such as Employer Stop Loss, Travel, Short Term Medical, Medical Travel, Workers Compensation, and/or Occupational Accident.

Responsibilities

• Schedule, coordinate, and monitor annual audits as an Audit Coordinator.
• Conduct first-level reviews of required reports prepared by Program Management Team members.
• Oversee Program Team member functions and support a relationship-based culture while managing a diverse portfolio of products and administrators.
• Serve as a liaison to administrative, operations, and underwriting areas of the company.
• Address relevant issues with distressed customers professionally and participate in team members’ client meetings, addressing open issues at least monthly.
• Address technical issues and coordinate with IT to seek resolutions.
• Assign or assist with onboarding new clients.
• Establish long-term customer relationships through prompt and courteous service.
• Assist with due diligence of new program administration business, including onsite reviews and assessments, and provide Management with operational assessments of prospective partners.
• Assist with annual administrator reviews to assess compliance with company requirements and identify process gaps and improvement opportunities.
• Monitor claims activity at least quarterly to identify outliers.
• Identify processing, system, and operational issues to help ensure claims are paid consistently with policy terms.
• Prepare monthly reporting packages for Senior Level Management, including inventory, first-level customer service and turnaround statistics, and referral analysis.
• Analyze claims-related litigation and regulatory inquiries monthly to identify trends and exposure.
• Analyze claims referral logs at least quarterly and recommend authority-level adjustments as appropriate.
• Refer small claims litigation to the Legal team and assist as needed.
• Review attorney correspondence and coordinate responses with administrators.
• Assist Compliance with reviews of claims-related regulatory inquiries.
• Draft and periodically update internal Claims Best Practices documents covering standards, procedures, and workflows.
• Oversee the Program Management Team’s review of TPA Best Practices to ensure administrators understand and follow applicable state unfair claims practices laws.
• Continue developing the Program Management Team’s product knowledge and broader perspective beyond claims audits.
• Use real situations, including distressed administrators, as educational and development opportunities for team members.
• Perform other duties as assigned.

Benefits

• Competitive compensation package.
• Generous 401(k) employer match.
• Employee Stock Purchase Plan with employer matching.
• Generous paid time off.
• Benefits supporting physical, mental, and financial wellbeing, including health, dental, and vision coverage.
• Tuition reimbursement, industry-related certifications, and professional training.
• Matching donation program, volunteer opportunities, and an employee-driven corporate giving program.
• Potential eligibility to participate in discretionary equity-based compensation and/or performance-based variable pay programs.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level