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Claims Manager - CA and AZ jurisdictions - Hybrid Position

Claims Manager - CA and AZ jurisdictions - Hybrid Position

**MUST HAVE CALIFORNIA AND ARIZONA EXPERIENCE**

If interested, please contact Tammy Galey 480-384-5916 or apply online at ccmsi.com


Summary:

 

Responsible for the investigation, adjustment and supervision of assigned claims.  This position is responsible for the supervision and coordination of all claim staff and functions within the claims area.  This position may be used as an advanced training position for consideration for promotion to the next level of management.

 

Essential Duties & Responsibilities:

 

Review, assign and provide supervision of all claim activity for designated claims to ensure compliance with Corporate Claim Standards, client specific handling instructions and in accordance with applicable laws.


Investigate, evaluate and adjust assigned claims in accordance with established claim handling standards and laws.


Reserve establishment and/or oversight of reserves for designated claims within established reserve authority levels.


Provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims.  Negotiate any disputed bills or invoices for resolution, as appropriate.


Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.


Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.


Direct handling of designated litigated and complex claims. 


Provide education, training and assist in the development of claim staff.


Review and maintain personal diary on claim system.



Supervision of all claim activity for specified accounts.


Attend account Board Meetings, conduct file review meetings and/or training sessions with clients, as requested.


Attend and participate at hearings, mediations, and informal legal conferences, as appropriate.


Performance appraisals and objective/goal setting and attainment of claim staff.


Remain current on all legislative activity (both federal and state), industry and market trends to ensure that all staff members are appropriately informed and understand the impact of these developments. 


Develop revise and implement workflow processes to ensure efficiencies and provide oversight of individual caseloads, as appropriate.


 Monitor compliance with Corporate Claim Handling Standards and special client handling instructions statutes, rules and regulations, and relative case law.


Performs other duties as assigned.

 


Qualifications:


To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

Excellent oral and written communication skills. Initiative to set and achieve performance goals.  Good analytic and negotiation skills.  Ability to cope with job pressures in a constantly changing environment.  Knowledge of all lower level claim position responsibilities. Must be detail oriented and a self-starter with strong organizational abilities.  Ability to coordinate and prioritize required.  Flexibility, accuracy, initiative and the ability to work with minimum supervision.  Discretion and confidentiality required.

 

Reliable, predictable attendance within client service hours for the performance of this position.


Responsive to internal and external client needs.


Ability to clearly communicate verbally and/or in writing both internally and externally.

 

Education and/or Experience    

 

Bachelor’s Degree or 15+ years claim experience.

Three years supervisory experience required.

 

Computer Skills            


Proficient with Microsoft Office programs. 


Certificates, Licenses, Registrations 

 

AIC, CPCU or ARM Designation preferred.

 

 

WORKING CONDITIONS

 

Physical Demands 

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


Object Handling Categories

Work requires the ability to lift/carry objects routinely as follows:

       Heavy Lifting:        Objects weighing 35-50 pounds lifted on a regular basis. Mechanical lifting devices (carts, dollies, pallet jacks, forklift trucks, etc.) or team lifts should be utilized.

             Medium Lifting:   Objects weighing 15-35 pounds lifted on a regular basis.

       Light Lifting:          No lifting of objects weighing more than 15 pounds on a regular basis.


 

Other Physical Demands (check all that apply)

       Work requires the ability to sit or stand up to 7.5 or more hours at a time.

       Work requires the ability to stoop, bend, reach and grab with arms and hands, manual dexterity,

       Work requires sufficient auditory and visual acuity to interact with others

       Work requires color vision

 

 

 

CORE VALUES & PRINCIPLES 

Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example.

 



Additional Info

Job Type : Full-Time

Education Level : ""

Experience Level : Mid to Senior Level

Job Function : ""

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