What are the responsibilities and job description for the Claims Manager position at Troxellins?
CLAIMS MANAGER
About Us
Top trusted risk advisor and solution provider for personal and business insurance where we work together to create the ultimate experience. We educate, advocate, and protect our people. We safeguard your future. We win by protecting people.
About the Role
The Claims Manager will coordinate the handling and processing of client claims to proper conclusion, including reviewing for adequacy, completeness, and accuracy. Will also provide guidance, assistance, and follow-up in all aspects of customer claim service requests from management, producers, or clients. Will train and mentor new employees while promoting the Company’s Core Values.
What You’ll Be Doing (Essential Responsibilities)
- Conduct detailed reviews of client policy claims for accuracy in completeness, documentation, and signatures; coordinate electronic input of claim transactions, submit loss requests to appropriate carrier adjuster, or to management if under agency draft authority, and ensure documents are delivered/mailed to appropriate parties.
- Prepare requests to clients for additional information if necessary for the processing of claims. Provide education on best outcome. Work closely with carrier and insured to get a timely resolution. Respond to inquiries and complaints from customers in a courteous and professional manner.
- Provide assistance to producers, customer service staff, and management in researching or interpreting insurance claim language and coverage, and likelihood of claim acceptance.
- Maintain frequent contact in person, by phone and mail (electronic/postal), with carriers, producers, clients, and management to facilitate appropriate and professional customer claim service.
- May conduct informational presentations to client employee benefits meetings; may accompany producers to meet with new clients to establish understanding of the claim benefits program.
- Maintain electronic and/or paper files in an orderly, timely manner. Contribute to a suspense system to ensure follow-up on outstanding or pending business matters.
- Act as a mentor/trainer to new employees including the administrative support staff. Will be in the office during training.
- Responsible for finding efficient ways to work with systems and internal processes. Will give recommendations as needed.
- Actively manage and review claim reserves in partnership with carriers and clients to ensure accuracy, timely adjustments, and optimal financial outcomes, supporting overall client and organizational profitability.
- Handle more complex claims.
- Be a role model for Troxell’s Core Values and exhibit engagement within the team.
- Perform special projects at management’s request.
You Will Succeed by:
Working Together. Collaborative | Inclusive | Open Communication
Creating WOW. Professional | Consistent | Passionate
Earning Trust. Positive | Empathy | Respect
Embracing Innovation. Proactive | Problem solvers | Openminded
What You’ll Bring to Us
- High School Graduate or GED required. Advanced training at technical, business, or college level is highly desired.
- 3-5 years prior account management or claims experience in the insurance industry.
- Experience with handling personal and commercial claims is desired.
- Property & Casualty License and Life & Health License at hire or within 180 days of hire. Must maintain during employment.
- Excellent written and verbal communication skills and enjoy working with people in a high-volume customer service environment.
- Must be highly organized, yet flexible, in dealing with shifting priorities, fluctuating workloads, and evolving procedures.
- Must be proficient in reading and interpreting complex industry documents such as policy limitations, underwriting standards, and procedure/policy manuals, and apply within prescribed routines and practices.
- Ability to thoroughly analyze product information and make timely and practical recommendations to managers, producers, and clients.
- Ability to work independently with limited supervision while maintaining positive staff relationships within a teamwork environment.
- Must demonstrate competence in computers and office operations. Experience with MS Office products (Word and Excel) and the Internet are highly desirable.
What We Need You to Know
- Full-time
- Hours are 8:00 am to 4:30 pm
- Travel: Minimal
The Fine Print
- Work is typically performed in a standard office setting with minimal travel required.
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- May be required to work more hours than normally expected during a regular workweek.
- Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
TROXELL is an Equal Opportunity Employer and offers a competitive salary with a comprehensive benefit package including Medical, Dental, Vision, Flexible Spending, Employer Paid Life Insurance, Short Term and Long Term Disability, 401(k) with Employer match, Paid Time Off, and Continuing Education.