Manager, P & C Claims (Workers Compensation & General Liability)

BlueCross BlueShield of South Carolina•Columbia, SC

4d•Hybrid

About The Position

Responsible for the management of assigned claims operation(s) to ensure that investigation and adjudication of claims meet established performance standards and objectives. Position may be assigned to multiple lines of business, contracts, and specialty claims operations. This is a full-time position, with a Hybrid schedule, working an 8-hr. shift (40-hours/week) Monday-Friday 8:00am – 4:30pm with primary location at 17 Technology Circle Columbia SC, Columbia, SC 29203. Due to the hybrid nature of the schedule, qualified, local candidates need apply. Sponsorship: This position is not eligible for sponsorship, now or in the future.

Requirements

Bachelor's degree (see degree equivalency below)
4 years job related work experience or Associate's and 2 years job related work experience.
2 years of area related adjusting experience.
Valid adjustor's license in required states or ability to acquire within 6 months-if required by the resident state's department of insurance.
Analyzes laws, regulations and contract language.
Evaluates issues and develops recommendations.
Handles confidential and sensitive information.
Investigates assigned claims.
Proposes claims adjustments and refunds.
Works claims caseloads.

Nice To Haves

Prior management experience directly related to position assignment (i.e. WC, Liability, TPA, or specialty operations).
Strong decision-making skills and an ability to work independently with limited direction while leading others.
Microsoft Office; Ability to manage various Claims Operating Systems.

Responsibilities

Provides management and oversight of claims to ensure performance standards are maintained including investigation and adjudication of claims, file documentation and management, reserving practices, pursuit of recovery and other account specific or contractual requirements.
Develops and maintains effective working relationships with external business partners to include insureds, agents, self-insured clients, vendors, defense firms, and other business partners for assigned lines of business, contracts or specialty claims operations.
Responsible for development and maintaining effective working relationships with other operational and support areas.
Responsible for development of claims staff, vendors, and contractors to ensure quality claims handling and outcomes. May include identification of training needs, implementation of educational programs, process changes, performance management, and audit functions.
Completes requests for proposal, bids, and due diligence efforts on potential new jurisdictions, contracts, or specialty claims programs.
Responsible for effective implementation and management of new business opportunities.
Assists claims senior management team in achieving both departmental and corporate strategies and goals.