Claims Manager Jobs

About The Position

Requirements

• Minimum five years of experience.
• Risk and claims management experience, including at least two years of insurance experience, such as work with a carrier, broker, or third-party administrator.
• Experience with Microsoft Office, including Word, Excel, PowerPoint, and Access.
• Effective verbal and written communication skills and the ability to interact effectively with internal and external business partners.
• Strong analytical and problem-solving skills.
• Excellent organizational skills, including the ability to prioritize and coordinate multiple tasks and projects.
• Ability to make independent decisions and solve problems based on precedents and established guidelines, while knowing when to refer issues to a supervisor.
• Ability to work both in a team environment and independently.
• Ability to maintain confidentiality.
• Ability to interact professionally and effectively with all levels of the organization.
• Travel to communities is required.

Nice To Haves

• Bachelor’s degree from a four-year college, or an equivalent combination of education and training.
• Relevant experience in corporate or regional risk management for a senior living operator, professional liability claims for a carrier, broker, or third-party administrator, or healthcare risk consulting.
• Experienced litigation paralegals with demonstrated insurance reporting and incident investigation experience will also be considered.
• Nursing background.
• Excellent knowledge of claims management, HR practices, principles, and workers’ compensation laws and regulations.

Responsibilities

• Review incident reports for completeness, accuracy, severity, and liability exposure; obtain missing information and assist communities with accident investigations and reporting.
• Conduct and coordinate factual investigations, including interviews, timelines, records, and witness identification, in partnership with clinical and operations leaders.
• Escalate matters under established criteria to the General Counsel, clinical and operations leadership, or carriers; maintain organized investigation files and track open items to completion.
• Preserve records, communications, video, and other evidence under established protocols and counsel’s direction.
• Review claims in online systems daily; identify reportable incidents, claims, and circumstances; assist the General Counsel with timely and accurate insurance notices and supporting materials; and track acknowledgments and follow-up requests.
• Maintain a claims register with status, key dates, assigned adjusters and counsel, and action items.
• Monitor claims activity and deadlines, obtain updates, escalate significant developments or delays, and assist counsel in preparing factual summaries for evaluation, mediation, and resolution.
• Under counsel’s direction, coordinate discovery records, factual information, and identification of witnesses and custodians.
• Protect sensitive information and follow counsel’s instructions on confidentiality, privilege, and document preservation.
• Analyze incident and claims trends, frequency, and severity by region and community; identify recurring causes and reporting gaps; and report significant matters, trends, and corrective actions to the General Counsel.
• Partner with clinical and operations leaders to develop and track corrective actions and initiatives that reduce claim frequency and severity and improve policies, reporting, investigations, escalation criteria, and claims workflows.
• Train and guide community teams on reporting, documentation, and investigation expectations.
• Perform other duties as assigned.

Benefits

• Health benefits
• Dental benefits
• Vision benefits
• Retirement benefits
• Short-term disability
• Long-term disability
• Paid time off
• DailyPay access to earned but unpaid wages before the next payday