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Role of Claims Manager
- Manages insurance claims departments
- Oversees intake and processing of claims for personal, property, or casualty loss based on coverage, appraisal, and damage
- Manages appraisal and examination staff and processes
- Assures timely and proper disposition of claims based on policy
- In litigation, discusses matter with legal counsel and aids in pursuing
- Records report of claim by phone, online, email, or post
- Handles cashless, reimbursement, and investigation for suspected claims
- Surprise hospital visits to validate cashless claims for pre-existing diseases, fraud
- Develops and implements procedures for great customer service and lower costs
- Leads team of analysts and processors, ensuring proper workload and productivity to meet targets
- Reviews and updates claim forms to ensure completeness and compliance
- Must have estimating systems knowledge and background in personal property coverage and policy
- Should have investigative skills and ability to deliver quality claims service
- Should have proven record of building and managing claims staff
- Serves as liaison between clients, adjusters, providers, and parties involved in claim
- Needs excellent communication, negotiation, and leadership skills
- Relevant experience required
- Bachelor’s degree in business, finance, or insurance recommended
What is the Role of Claims Manager?
- Manages insurance claims departments
- Oversees intake and processing of claims for personal, property, or casualty loss based on coverage, appraisal, and damage
- Manages appraisal and examination staff and processes
- Assures timely and proper disposition of claims based on policy
- Handles cashless, reimbursement, and investigation for suspected claims
- Surprise hospital visits to validate cashless claims for pre-existing diseases, fraud
