Manager, Claims (Workers Compensation) Details

ICW Group - Woodland Hills, CA

Employment Type : Full-Time

ICW Group is looking for a Claims Manager in Woodland Hills, CA. The Claims Manager will ensure the claims department is supported effectively. This position oversees the technical product of the regional claims department(s) to assure that practices comport with state compliance regulations. This position exists to ensure proper claim handling techniques to protect the integrity of our brand and providing consistent service quality and streamlined processes to add value for our customers.

WHAT YOU WILL BE DOING:

Monitors claims to ensure company and state requirements are met while achieving the best possible outcome.

  • Reviews and audits claim files to make sure that ICW Group’s and the states’ W/C expectations are met daily.
  • Ensures claims are processed aggressively to achieve the best possible result and an acceptable closing ratio.
  • Maintains regular review of reserves to ensure each open file adequately reflects the reasonable ultimate cost of the claim.
  • Consistently explores opportunities for improvement to enhance efficiency and optimize margin.
  • Implement strategies and initiatives to improve file quality, customer service and manage costs.

Manages a regional Claims Team in the performance of their daily activities.

  • Ensures that all ICW Group practices and procedures, and state regulations governing the processing of claims and reporting of losses, are practiced daily for state(s) managed out of the branch.
  • Identifies staffing requirements and allocates resources where needed to ensure consistency in workflow and production efficiencies.
  • Identifies and provides applicable resources (including vendors) for all team members to meet expectations, daily.
  • Manages multiple branch expenses daily.
  • Promotes and encourages effective communication with all team members daily, for multiple branches.
  • Completes and shares applicable reports to staff, agents, and Home Office as necessary.

Develops and leads a team of regional claims professionals to ensure daily operational success.

  • Provides daily direction to the team. Communicates Mission, Values, and other organization operating principles to direct reports.
  • Establishes and maintains the overall work cadence and, in partnership with Department leadership, ensures performance and outcomes strive for excellence in delivery and customer experience. Ensures that the entire team is engaged and that leadership practices encourage development, recognition, and retention.
  • Establishes and adheres to hiring criteria, on-boarding, and training requirements for incoming staff.
  • Oversees the performance management and development process for the team and performs performance management duties, development planning and coaching for direct reports.
  • Acts as a resource for team members to answer questions and solve complex problems.
  • Manages budget, technology and other resources, workload, and customer requests for Department services. Ensures adherence to all Company policies and procedures and Compliance responsibilities.
  • Ensures data quality, adherence to IT security guidelines, profitability and other risk-related metrics for self and members of the team.

SUPERVISORY RESPONSIBILITIES

Directly supervises 2 or more employees within the Claims team 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

  • High school diploma or general education degree (GED), required.
  • Bachelor's degree from four-year college or university preferred with a major or emphasis in Business Administration, Management, or related field.
  • Minimum 5 years of related workers’ compensation claims experience and/or training; or equivalent combination of education and experience required.
  • Minimum 1 year experience as a Supervisor for claims professionals required.

CERTIFICATES, LICENSES, REGISTRATIONS

Insurance Education Association (IEA) Certificate, Workers Compensation Claims Professional (WCCP) Accreditation preferred. Chartered Property Casualty Underwriter (CPCU) designation a plus.

KNOWLEDGE AND SKILLS

Working knowledge in an examiner’s role. 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.

WORK ENVIRONMENT

This position operates in an office environment and requires the frequent use of a computer, telephone, copier, and other standard office equipment. Required to travel 15%.

Posted on : 3 years ago