Casualty Claims Manager
- Employer
- James River Insurance Company
- Location
- Richmond, Virginia
- Salary
- Starting at $80,000
- Posted
- May 18, 2018
- Closes
- Jul 17, 2018
- Category
- Claims, Executive / Management
- Job Type
- Full Time
- Career Level
- Manager
Job Summary
The Claims Manager guides and directs the operations of the Claims Team in conducting the investigation, evaluation and disposition of claims and suits brought against James River Insureds. Each Claims Team supports multiple Underwriting Divisions. Reporting to the Claims Manager are Claims Examiners, Senior Claims Examiners and Claims Specialists, each of whom handles claims within one or more line(s) of business. The Claims Manager functions with autonomy to conduct team meetings, monitor caseloads, extend reserve and settlement authority and authorize referrals to both defense counsel coverage counsel when needed. The Claims Manager facilitates the setting of goals and objectives with direct reports, measures results and conducts annual performance reviews. The Claims Manager conducts monthly Claims Quality Reviews on at least two claim files for each claim handler. Claims Managers may be responsible for chairing or co-chairing committee claim review meetings, overseeing the Claims Technician, coordinating IT projects including Claims Dashboard, interacting with ISO for reporting claims that may involve Medicare, Medicaid, coordinating Accounting requests to reconcile various claim payments or discrepancies in 1099 forms and updating panel counsel list. Claims Managers are also responsible for initiating Quarterly meetings with each Underwriting Division they support to share claims information, report on unique claims, discuss frequency or severity issues, etc.
Job functions: Reviews and assigns all newly reported claims and suits to direct reports; provides guidance and direction for all of the following activities:
- Analysis of coverage issues and taking appropriate action;
- Analysis of the facts and allegations to determine the extent of liability;
- Evaluation of causation and damages to determine potential exposure;
- Setting appropriate reserves to reflect probable outcome;
- Taking appropriate action to move the case toward resolution through alternative means, i.e., mediation, arbitration, trial, settlement.
- The Claims Manager uses excellent oral and written communication skills to interact with the Claims Team, brokers, claimants, attorneys and policyholders regarding developments in the claim or suit.
- The Claims Manager ensures that all state regulations and internal guidelines are met by the team, and that each member of the Team manages claims and suits in accordance with James River Claims Best Practices.
- The Claims Manager functions with autonomy and is a key resource person on claims for the Underwriting Divisions they support.
Duties and Responsibilities
- Continuously exhibit and uphold Core Values of Integrity, Accountability, Communication and Teamwork, Innovation and Customer Service
- Supervises claim files handled by direct reports
- Performs an initial analysis of coverage, liability and damages on all claims assignments
- Reviews disclaimers and reservation of rights letters written by direct reports
- Delegate’s responsibility to assign claims to independent adjusters and to refer cases to defense attorneys
- Negotiates some settlements directly and provides oversight for direct reports, who conduct negotiations, mitigate damages and control expenses
- Oversees management of litigated files
- Maintains a high level of communication with leadership
- Works within authority limits and makes recommendations if higher authority is needed
- Guides and directs the handling of complex high exposure claims and suits
- Recognized as the key company claims contact within specialty area
- Provides technical guidance, assistance and training as needed for claims staff and other departments
- Assists the VP in managing the Claims Department
Knowledge, Skills and Abilities
- Thorough knowledge of claims, strong leadership skills, recognized ability to manage a team of Claims Professionals
- Excellent written and oral communication skills
- Strong analytical skills
- Strong negotiation skills
- Self motivated, ability to motivate others, ability to delegate authority
- Well organized and possessing proficient computer skills
- Able to work successfully in a team environment
- Able to lead, guide and direct a team and also take direction from VP Claims
- Superior knowledge and skills in a variety of claims specialty areas
- Excellent record of achievements that clearly set the individual apart from others
Experience and Education
- High School Degree required
- Bachelor’s degree, Advanced degree or Law degree preferred but not required
- Seven to ten years of claims handling experience
- Extensive expertise in specific specialty area of claims (i.e. PL, GC, M&C)
- Experience in working with complex coverage issues
- Multi-jurisdictional claims and litigation experience
- Adjuster license and/or certifications desired but not required