JOB DESCRIPTION:

The Claim Processing Manager oversees the adjudication of insurance claims to ensure the fair settlement of claims within carrier and state guidelines; responsible for maintaining positive relationships with carrier partners & external vendors; responsible for inventory management and ensuring service levels and quality metrics are met; responsible for performance management, coaching & mentoring staff; tasked with ensuring processing guides are kept up to date.

Key Responsibilities:

• Directly manage a team and actively participate in the management of the team by Coaching, mentoring, and leading team members to foster a collaborative environment and ensure high performance by the team.
• Responsible for claim decisions up to the carrier authority limit.
• Responsible for inventory management, assignment of work, and ensuring service levels and quality metrics are met.
• Responsible for performance management and the accurate calculation of monthly claim production and quality metrics by team and staff member.
• Set departmental goals and mentor team members to ensure accountability for the achievement of goals and objectives.
• Develop and maintain positive relationships with carrier partners & external vendors.
• Lead carrier review meetings and be an active participant in audits.
• Partner closely with claims leadership & other managers to foster teamwork and ensure we are putting the customer first and getting tasks completed.
• Work with team members to identify, develop, and implement departmental process improvements.
• Maintain and create process documentation to ensure the team has appropriate reference material.
• Ensure departmental and carrier reporting is accurate and delivered on time.
• Participate in projects & product testing as required.

QUALIFICATIONS:

• Education: Bachelor's Degree or equivalent experience preferred
• Experience:
  • Minimum of 5 years managing teams with high work volumes
  • Prior insurance or claim processing leadership role preferred
• Certifications:
  • Property & Casualty Adjuster License required or ability to obtain one
  • Certified Fraud Examiner [CFE] preferred
• Software: proficient in MS office and other relevant software. Excel a must.

Seven Corners, Inc. is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, age, status as a protected veteran, among other things, or status as a qualified individual with disability.