Casualty Claims Manager

Salary Grade 15: $93,695 – $119,460 – $145,226. Hybrid schedule: 3 days in-office, 2 days remote.

About the role

The Casualty Claims Manager coaches and develops a team of 5–8 internal and external Claims Adjusters, Senior Claims Adjusters, and Claims Specialists responsible for the management, investigation, and resolution of claims. This role promotes a culture of claims customer-service excellence and ensures staff properly manage an appropriate caseload in accordance with company standards and state regulations (IC 27-4-1 / ORC 3901-1-54).

Responsibilities

• Leads and develops a team of Claims Adjusters, Senior Claims Adjusters, and Claims Specialists, ensuring quality, accuracy, and timely resolution of claims, including high-exposure, complex cases, and litigation.
• Proactively assists in selecting top talent, delivers continuous coaching, and rewards and recognizes employees to reinforce service-excellence behaviors.
• Assesses volume and nature of claims to be assigned and provides direction on losses to claim representatives as appropriate.
• Direct involvement on select claims (significant exposure or complexity).
• Reviews reserve amounts on high-cost claims and claims exceeding the authority of Claims Adjusters, Senior Claims Adjusters, and Claims Specialists.
• Ensures effective communication with Underwriting, Agents, Insureds, and Counsel.
• Ensures compliance with all statutory and unfair-claims-practices acts.
• Monitors team members to ensure reserves are adequately set and customer expectations are surpassed.
• Conducts monthly audits of the claims process (coverage analysis, investigation, valuation, scope, estimate, reserving, timeliness, and accurate disposition) and provides feedback for continuous improvement.
• Analyzes problematic trends and takes steps to avoid recurrence, escalating issues as needed.
• Participates in monthly reviews of litigation and complex files with in-house counsel, VP Claims, AVP Claims, and assigned Claims Adjusters/Specialists.
• Promotes a culture committed to identifying process inefficiencies to continuously improve workflow.
• Presents complex cases to the roundtable committee.
• Attends and participates in mediations, pre-trials, and trials.
• Resolves customer complaints.
• Advocates business-unit goals and ensures alignment with broader claims functional goals.
• Organizes and conducts training for new employees.
• Conducts performance evaluations and salary reviews of staff.
• Maintains a regular diary system and reviews system reports to identify claims for quality and regulatory compliance.
• Actively participates in or leads continuous-improvement projects.
• Stays current on industry trends and changes in insurance laws and regulations impacting claims handling.
• Acts as a back-up for other unit Managers and adjusters during their absence.
• Performs administrative activities: reviewing, preparing, and running reports; preparing follow-up letters to insureds regarding coverage; attending agency meetings and functions.
• Reviews claims regularly for coverage, adequate reserves, and accuracy; acts as a resource for answering claims questions.
• Works with SIU on fraudulent claims and coordinates with the Legal Department on litigated files.
• Resolves coverage or unusual questions within designated authority; conducts related research as necessary.
• Evaluates potential services or vendors that may increase efficiency, accuracy, or quality, or reduce expenses while maintaining quality customer service.
• Makes recommendations to and participates with leadership in developing and evaluating claims procedures.
• Provides recommendations and technical assistance on business-system development, implementation, and testing.
• Develops, analyzes, and reports metrics useful in measuring performance and effectiveness of team operations.
• Travels as needed relevant to the position.

Requirements

• Minimum of 5 years of Casualty or General Liability claims experience.
• College degree or equivalent experience.
• Extensive experience in appropriate reserving procedures, effective negotiation skills in Personal, Commercial, General Liability, and Property coverage, and settlement practices.
• Excellent written and verbal communication skills.
• Extensive experience directing Independent Vendors and Coverage Counsel.
• Superior interpersonal skills.
• Efficient time-management skills.
• Ability to apply common sense, reasoning, and sound judgment to evaluate and analyze claims for recommended action within assigned authority levels.
• AIC or CPCU designations highly preferred.

Supervisory Responsibilities

Supervises 5–8 direct reports.

Physical Demands

• Regularly required to sit, talk, or hear; frequently required to use hands to finger, handle, or feel.
• Occasionally required to stand, walk, and reach with hands and arms.
• May require extended periods of sitting in a vehicle for travel.

Work Environment

• Hybrid work environment: 3 days in-office, 2 days remote.
• Work area includes personal computer, telephone, file space, and work table space.
• Moderate noise level from telephone calls and interaction with team members.