Claims Manager

I – GENERAL FUNCTION:

A Claims Manager is responsible for planning, organizing, managing, evaluating and coordinating activities of the claim adjudication. Also, the Claims Manager will support and administer corporate policies, procedures, and philosophies to promote quality service and indemnity objectives.

II – DUTIES & RESPONSIBILITIES:

• Providing overall directions, supervisions and trainings to the Claims staff through delegation of work assignments, projects, periodic meetings, and tasks required to satisfy corporate goals, objectives, and strategies
• Developing, securing approval and implementing policies, procedures, and protocols necessary to achieve short and long-term goals and objectives for all product lines to ensure appropriate turnaround time and levels of service levels are maintained
• Communicating and adhering corporate policies and procedures, interpret and administer departmental objectives and quality standards consistent with guidelines established
• Interviewing, evaluating and selecting suitable personnel for the department
• Reviewing the evaluations of employee performance and recommending appropriate coaching, training, developing, and corrective actions for assigned departmental staff
• Producing, analyzing, monitoring, and distributing departmental reports to identify key quality, productivity and service measures
• Maintaining knowledge of current trends and developments in the field through the periodic review of books, journals and literature; Attending related and appropriate seminars, training sessions, and conferences for continued education
• Other duties assigned by the Director of Operations and the Head of Claims

III – QUALIFICATIONS:
• University degree in Business Administration, Finance, or Management required, in the Insurance Industry is preferred
• Ability to plan, organize, develop, implement and evaluate activities and results as they relate to goals and objectives
• Problem-solving, analytical and decision-making abilities
• Ability to cultivate and maintain interpersonal relationships with a broad cross-section of diverse people
• Oral and written communication, management, organization and interspersion skills
• Knowledge of insurance industry operations, health care benefits, structures, policies and procedures

- Competitive salary and bonus
- Healthcare Insurance
- Professional, dynamic working environment

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