Claims Branch Manager

Woodland Hills, California

 

PURPOSE OF THE JOB

The purpose of this job is to manage functions and technical product of a select claims branch so that claims are processed expeditiously, efficiently, and cost effectively. This position exists to assure that branch practices comport with state compliance regulations and with company fiscal policy.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Manages technical product of the Claims branch to assure compliance with applicable constituencies.

  • Provides applicable training to meet state requirements and correct adverse trends in assigned branch.
  • Assures that all ICW practices and procedures and state regulations governing the processing of claims and reporting of losses are practiced daily for multiple states.
  • Escalates cases/files exceeding own settlement and reserve authority with recommendations and data points to the Regional Director or VP of Claims.
  • Ensures Claims branch is in compliance with state regulations, Company policies, and other related agencies.
  • Identifies and provides applicable resources (including vendors) for all team members to meet expectations, daily.
  • Reviews and audits claim files in assigned branch to make sure ICW and state compliance expectations are met daily.
  • Ensures that claims are processed aggressively to achieve the best possible result and an acceptable closing ratio.
  • Completes and shares applicable reports to staff, agents, and Home Office as necessary.

Drives processes and makes decisions that ensure claims are processed expeditiously, efficiently, and cost effectively.

  • Establishes team member reserve authority amount.
  • Holds team members accountable for following established Company processes.
  • Advises team on claim closure strategies, legal ramifications, cost saving ideas, and negotiating skills.
  • Monitors claim volume to adjust staffing needs as necessary.
  • Produces and analyzes financial reports and branch performance data.
  • Creates and executes action plans aimed at improving results.
  • Works closely with the V.P. of Claims to manage branch/department budgets.
  • Approves up to $500 dollars of branch expenses daily.

Manages the performance of a branch unit of claims professionals.

  • Directs the assigned management team members (Supervisors and Managers) in the handling of claims to ensure that they are handled in compliance with best practice expectations and applicable state laws.
  • Sets performance expectations, branch, team and individual goals and timelines in alignment with department management.
  • Provides organization and skill development for all team members.
  • Ensures staffing coverage for the team is available to support customer needs.
  • Promotes and encourages effective communication with all team members.

SUPERVISORY RESPONSIBILITIES

Directly manages employees in a supervisory capacity and carries out supervisory responsibilities in accordance with company policies and applicable laws. These responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; conducting performance and salary reviews; rewarding and disciplining employees; addressing complaints and resolving problems; coaching, mentoring, and developing team members to further their skills and knowledge; creating and monitoring development plans; setting performance expectations/goals; forecasting staffing needs and planning for peak times and absences; enforcing department policies and procedures.

EDUCATION AND EXPERIENCE

Bachelor's degree from four-year college or university: Business Administration, Management or related degree, preferred. Minimum 7 years of examining experience and 2 years of supervisory experience over claims professionals required.

CERTIFICATES, LICENSES, REGISTRATIONS

Adjuster Certification of Workers' Compensation may be required depending on Branch and/or State.

KNOWLEDGE AND SKILLS

Advanced understanding of Workers' Compensation claims principles and application. Strong understanding of personnel and performance strategies. Excellent verbal communication skills, time management and organizational skills. Requires a high level of attention to detail. Ability to effectively present information to top management, and/or public groups. Ability to define problems, collect data, establish facts, and draw valid conclusions.

PHYSICAL REQUIREMENTS

Office environment – no specific or unusual physical or environmental demands and employees are regularly required to sit, walk, stand, talk, and hear.

COMPETENCIES

This position maps to the Manager level. Additional competencies required: Insurance Industry Knowledge and Strategic Thinking.

WORK ENVIRONMENT

This position operates in an office environment and requires the frequent use of a computer, telephone, copier, and other standard office equipment.

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