Manager, Claims

SUMMARY
Responsible for leading and overseeing Liability claims team including ensuring appropriate coverage determinations, preparation of coverage position letters, litigation management, and allocation of fault and liability determinations. Ensuring claims are handled fairly, efficiently, and in accordance with policy terms, service standards, contractual requirements, and applicable laws and regulations.
ESSENTIAL DUTIES AND RESPONSIBILITIES

Manages claims governance, service providers, performance reporting, escalations, and team development while using claims insight to improve outcomes.
Establishes and maintains claims governance, procedures, service standards, authority levels, escalation protocols, and performance measures.
Oversees claims activity to support timely, accurate, fair, and commercially appropriate outcomes consistent with policy terms and underwriting intent.
Reviews significant, complex, disputed, sensitive, or escalated claims and provides recommendations for resolution or further escalation.
Manages relationships with adjusters, defense counsel, experts, insurers, brokers, clients, and other service providers.
Monitors claims performance including claim volumes, severity, cycle times, reserving, litigation, recoveries, complaints, and large losses.
Uses claims data and experience to identify emerging risks, opportunities, coverage or process issues.
Coordinates claims audits and quality assurance reviews, including any State audits or reviews
Ensures claims records, data, documentation, decisions, and management information are complete, accurate, secure, and reviewable.
Promotes fair claims handling, appropriate outcomes, privacy protection, consistent treatment of claimants, and compliance with applicable legal and regulatory requirements.
Leads, coaches, and develops claims personnel; manages objectives, performance, training, staffing, succession planning, and use of external resources.
Identifies and implements improvements to claims workflows, technology, automation, controls, service quality, efficiency, and financial performance.
Represents the company at industry events, marketing opportunities and conferences.
Performs all duties in accordance with all company policies and procedures, and all federal, state and local laws, wherein the Company operates
Performs other duties as assigned.
QUALIFICATIONS EDUCATION / EXPERIENCE

Bachelor's Degree or equivalent combination of education and experience
Seven (7) or more years progressive experience in insurance claims, including complex commercial or specialty claims
Valid Insurance License

SKILLS
Strong knowledge of claims handling principles, policy interpretation, coverage analysis, reserving, litigation management, recoveries, and claims governance
Knowledge of applicable insurance laws, regulations, licensing requirements, privacy obligations, and fair claims handling expectations
Excellent verbal and written communication, presentation, negotiation, and stakeholder-management skills
Strong analytical, planning, organizational, prioritization, and problem-solving skills
Ability to interpret claims data and convert analysis into practical underwriting and business recommendations
Ability to exercise sound judgment, manage ambiguity, and resolve complex or sensitive issues
Ability to lead, motivate, coach, and develop staff and foster effective teamwork

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