Claims Operations Manager

Claims Operations Manager

This newly created position will manage the internal claim operations insuring best practices while maintaining overall claims quality control and customer service quality.

• Oversees budgeting/forecasting, and the implementation of budgets, to monitor progress and present operational metrics.
• Recommend process improvements aimed at ensuring best-in-class service.
• Exercise proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the claim.
• 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.
• Liaises with IT department to optimize systems performance
• Responsible for developing and refining the statistics and processes to assess quality and determine effective improvements and programs
• Analyze and work toward improvement of claim performance and quality through the use of metrics and quality assurance audits.
• Assist in consistently managing the claims processes; coordinate efforts with other claims functions such as QA, claims legal, subrogation, SIU, service centers, claims technical and claims staff support.
• Proven leadership and personnel management experience including motivating, training and developing teams and individuals
• Team player with willingness to work cooperatively across all departments and organizational levels to meet business objectives
• Demonstrated track record of success in supervisory/management

Experience

• Bachelor’s or Master’s degree
• Eight (8) years property and casualty insurance industry experience including claims administration within an claims operations environment.
• Homeowner technical knowledge a major plus including managing TPA's