Claims & Compliance Manager

Location
Lakewood Ranch / Sarasota
Salary
Competitive Salary + Comprehensive Benefits Package
Posted
Jul 08, 2019
Closes
Sep 06, 2019
Job Type
Full Time
Career Level
Manager

Centauri Specialty Insurance

Claims Manager

Company Description

Centauri Specialty Insurance is a growing property and casualty insurance carrier with a ton of positive energy regarding the future of our organization. Our current corporate staff of 40 tenacious professionals work together to solve problems to create effective products that meet the needs of our policyholders.  This position is in our new state-of-the-art building in Sarasota, Florida. 

Summary

Responsible for maintaining and reporting Claims Department metrics; claims compliance; day to day claims management to third party administrators;  under the supervision of the VP of Claims.

Job Description

The Claims and Compliance Manager is a crucial role within the Claims Department.  This key function will assist us in developing our strategies moving forward. 

Your Duties and Responsibilities include the following. Other duties may be assigned.

Claims Function:

  1. Claims and Compliance Manager Assists in the development, implementation and updating of claims best practices, policies, and procedures.
  2. Claims and Compliance Manager is Responsible for auditing and ensuring compliance with all applicable regulations, laws, and guidelines.
  3. Claims and Compliance Manager will Partner with Product/Underwriting, Sales, and Operational leadership to provide claim guidance for overall product design, marketing, and delivery.
  4. Claims and Compliance Manager Delivers a positive customer service experience to all internal, external, current and prospective customers.
  5. Claims and Compliance Manager will Assist in achieving overall organizational objectives and profitable growth.
  6. Claims and Compliance Manager Recommends process improvements aimed at ensuring best-in-class service.
  7. Claims and Compliance Manager Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the claim. 
  8. Claims and Compliance Manager must be Able to clearly communicate concise action plans, and present plans for moving the claim to conclusion.
  9. Claims and Compliance Manager is Responsible for claims/third party administration oversight that is consistent with corporate policies, procedures and "best practices" in accordance with any statutory, regulatory and ethics requirements.
  10. Claims and Compliance Manager Analyzes and works toward improvement of claim performance and quality through the use of metrics and quality assurance audits; coordinates efforts with other claims functions such as QA, claims legal, subrogation, SIU, service centers, claims technical and claims staff support.

Compliance Function:

  1. Claims and Compliance Manager Manages audits of TPAs. Claims and Compliance Manager Assists with internal audit tracking function. Claims and Compliance Manager Manages complaint process. Claims and Compliance Manager Manages Service of Process for claims litigation and suit tracking. Claims and Compliance Manager Assists with the subpoena process. Claims and Compliance Manager Functions as corporate representative in non-complex legal proceedings. Claims and Compliance Manager Manages select administrative functions.

What We Offer You:

  • Opportunity for Advancement
  • Generous health insurance package
  • 90% company paid benefit-rich Health Coverage
  • 100% company paid Dental, Vision, Disability and Life coverage
  • 401(k) with employer matching
  • Paid time off
  • 11 Holidays
  • 12 days of sick
  • 18 days of vacation annually
  • 16 hours of Community Volunteer time
  • Corporate events
  • Wellness Program with Fitness Reimbursement program
  • Tuition reimbursement
  • Business Casual Dress code

Required Qualifications:

Education: Bachelor's degree (B.A./B.S.) from four-year college or university preferred.

 

Licenses/Designations: State licensing where required.

 

Experience: Minimum five (5) years’ experience in a claim’s operation. 

 

Knowledge:        Requires advanced knowledge of claims best practices, technical claims operations, procedures and claims performance strategies and day-to-day claims operations.

 

Familiarity with ERM function

 

Required Skills:

  • Excellent customer focus to proactively identify and understand customer needs.
  • Ability to effectively communicate interpersonally with individuals and groups.
  • Demonstrated decision-making skills, including the ability to recognize, analyze and improve claims performance situations such as loss control, LAE, customer satisfaction, employee development and engagement.
  • Effective listening, oral and written communication skills necessary for customer contact, negotiation, presentations, and project management.
  • Adaptability and Flexibility.
  • Dependability and excellent time management skills.
  • Ability to handle stress.
  • Highest level of professionalism and integrity.
  • Ability to make decisions, establish priorities, and set strategic directions.
  • Ability to organize and deal with a variety of situations, discern problems and recommend/implement resolutions.
  • Ability to use Microsoft Office, including Word, Excel, PowerPoint, and custom project management and applicable software preferred.
  • Ability to travel 10 – 20%
  • Physical demands for this position are Light with a moderate to heavy stress level. 
  • Exerting up to 20 pounds of force occasionally and/or a negligible amount of force constantly to move objects. 
  • While performing the duties of this job, the employee is regularly required to sit; use hands; and talk or hear.
  • The employee is occasionally required to stand; walk safely over uneven terrain or in confined spaced; and reach with hands and arms.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Location

Centauri is in beautiful Sarasota, on the Gulf Coast of Florida.  Sarasota offers a variety of outdoor activities like fishing, sailing, swimming, kayaking, biking, golfing and running throughout the year. Cultural amenities with museums and art galleries and a collection of unique restaurants provide experiences to interest everyone.  Sarasota offers a strong economy with great schools, a variety of churches and family friendly parks and community activities.   Florida has NO State Taxes!

Please note: Completion of a satisfactory criminal record check, education verification and reference checks are required prior to employment.

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