Claim Manager Jobs

Assumes professional responsibility for development of skills and ongoing education to maintain certification.

Other specials projects set by the Revenue Cycle Manager.

Years of medical billing experience is required.

Knowledge of medical terminology is required.

Great communication and organization skills.

Basic excel skills such as the ability to perform or simple calculations with formulas and functions and format spreadsheets is required.

Minimum of 3 years Long Term Disability claim management experience

Technical and quality coaching on claims, contracts, content, and best approach while holding claim managers accountable for their work quality.

Proactively reviewing team’s inventory to identify trends and provide feedback to Team Leader and Claim Managers.

Demonstrates solid planning and organizational skills with the ability to address short- and long-term goals while prioritizing and addressing ongoing issues.

BA/BS degree or equivalent work experience

Strong analytical skills and ability to grasp and clarify complex and ambiguous concepts

6+ years management experience preferred.

Demonstrated exceptional leadership and management experience

Strong analytical ability, financial analysis/budgeting/expense management skills

Comprehensive Property Casualty insurance knowledge and experience preferred

Stays informed of industry trends and meeting customer needs in contact center design, strategy, workforce and new digital and omnichannel capabilities.

Works closely with CBIA, Claim Technology and BDO in the strategic development and implementation of Artificial Intelligence, digital and technology capabilities.

Ensure a positive customer experience Ensure timeliness and KPIs are being met

Maintain necessary licensing and continuing education.

Property and casualty experience required.

Preferred experience as a Claims Rep and or Subrogation Rep

Typically requires advanced knowledge of Microsoft Office Programs.

Work-Life Integration: other benefits including Mentally Fit Employee Assistance Program, subsidized and discounted Weight Watchers® program and other employee discount programs.

4-40 license with 2+ years of related experience or a 2-20 license as required by the State Department of Insurance.

Broad knowledge of personal lines insurance with a strong understanding of coverages and forms

Strong verbal and written communication skills are necessary.

Moderate to advanced knowledge of Microsoft Office Suite and the ability to learn other appropriate insurance company and firm software systems.

Responsible for filing claims on behalf of clients with the appropriate carrier in a timely manner either online or by phone.

Research and respond directly to partner underwriter memos, generate endorsement requests and cancellation forms.

• Provide administrative support for the team's management of disability claims.

• Experience: related work experience, or the equivalent combination of education and/or relevant experience

• Make and communicate disability decisions and issue correct benefits for low liability and short duration claims.

• Verify benefit claim documents.

• Working knowledge of Office equipment including a word processor or personal computer.

• Education: High School diploma or equivalent.

Prepare written investigative summaries, and report findings to the assigned claim handler, management, Underwriters, and others.

Required Qualifications (these are the minimum requirements to qualify)

Education (include minimum education and any licensing/certifications):

Five years of experience as a claim representative handling Auto or Home personal lines property insurance claims.

Maintain and continually expend expert knowledge on claim fraud scenarios and indicators

Engage and manage experts to complete specialized tasks

Prepare written investigative summaries, and report findings to the assigned claim handler, management, Underwriters, and others.

Education (include minimum education and any licensing/certifications)

Five years of experience as a claim representative handling Auto or Home personal lines property insurance claims.

Maintain and continually expend expert knowledge on claim fraud scenarios and indicators

Engage and manage experts to complete specialized tasks

Bachelor’s degree in Business Administration, Insurance, Criminology or a related field or the equivalent in related work experience

Fully and effectively utilizes available technology, case management system and automation.

In the handling of a caseload of predominantly low to moderate complexity, your responsibilities will include:

Develop and apply effective use of trial skills and techniques to litigate cases to verdict.

Conduct legal research and demonstrate strong and persuasive legal writing and presentation skills.

3+ years of prior litigation practice or prior legal experience

Developing a track record of trial skills and techniques.

Make decisions on how to utilize resources to meet goals and responsibilities set by higher level management.

Strong people management skills, effective at coaching and motivating staff. Serves as a role model in building effective relationships

Manage according to established expense, reserve and settlement authority levels.

Typically has 10+ years of complex liability claims experience

Ability to negotiate skillfully in difficult situations with both internal and external groups. Demonstrates ability to win concessions without damaging relationships.

Effectively and creatively utilizes all resources (systems, people, etc.) to manage daily operations

Coordinates with Document Management to obtain underwriting files and certified policies.

Paralegal or litigation experience preferred.

General knowledge of Medical Terminology preferred.

Advanced grammar and writing skills.

Intermediate Knowledge of general law office procedures and advanced knowledge of local court/jurisdiction rules and procedures.

Ability to manage time and tasks

Collaborate with physicians, claims operations, prior authorization, utilization management, local market teams and support staff as needed

Solid communication, presentation and writing skills

Solid knowledge of medical claims and medical necessity review processes

Intermediate experience using Microsoft Office applications (Word, Excel (pivot tables), PowerPoint)

Proven solid attention to detail and accuracy, excellent evaluative and analytical skills

2+ years of leadership experience

Previous management or supervisory experience.

Assist the management with establishing short, intermediate and long-term goals and objectives.

Knowledge and experience to include:

Prepare and present written and oral reports to all levels of management.

Manage teams with respect to assigned products and services.

Manage and administers claim review and auditing functions.

Prepare written investigative summaries, and report findings to the assigned claim handler, management, Underwriters, and others.

Bachelor’s degree in Business Administration, Insurance, Criminology or a related field or the equivalent in related work experience

Fraud Claim Law Specialist Certification, preferred.

Certified Insurance Fraud Investigator Certification, preferred.

Five years of experience as a claim representative handling Auto or Home personal lines property and casualty insurance claims.

Work experience in both claims handling as well as fraud investigation.

Manages Centralized Contents Team associates and/or Contents leads

Leads frequent meetings using relevant metrics, and devotes significant time directly coaching team members to achieve desired results

Develops and coaches team members to provide a high level of customer service and be productive in the role

Resolves escalated inquiries, issues, and related service follow-up for internal and external customers

Collaborates with other Fire claim environments on evaluating and settling contents claims

Analyzes trends and statistical reports, and provides recommendations for improving efficiency and effectiveness within assigned area

Work management skills: Time and workload management, Self-starter, Planning, Achievement orientation, Productivity focus

Interpersonal skills: Ability to influence others, Client and broker management skills, Purposeful communication, Flexibility, Active listening

Identification of issues and trends in the portfolio, consult management/peers if required, and take appropriate and/or corrective action.

Adhere to Beazley’s procedures for the selection and retention of 3rd party professionals and manage relationships to the benefit of Beazley.

Ensure the management of claims conforms to the agreed standardised processes and use of

Support the Claims Business Management Team and Claims Solutions Team to identify and implement business performance improvement opportunities.