Note: The job is a remote job and is open to candidates in USA. EMC Insurance Companies is focused on improving lives through teamwork and support. The Complex Casualty Claims Manager oversees a team handling complex casualty claims, ensuring compliance with company guidelines and fostering a culture of excellence in customer relations.

Responsibilities

• Oversees assigned complex casualty claims team.
• Reviews all complex claim files assigned to team and analyzes files for necessary facts, including reaching out to appropriate parties to gather any missing information.
• Assigns claims to the appropriate handler with the right skills and experience.
• Provides direction and recommendations for handling.
• Guides team through complex questions of coverage, compensability, liability, claim value and strategy for resolution.
• Handles complex commercial casualty claims.
• Reviews reservation of rights and denial letters and approves for sending to insureds.
• Assigns or assists in the selection of counsel and monitors litigated matters.
• Ensures that timely, adequate reserves have been established on claim files in compliance with the company’s reserve guidelines and methodology.
• Ensures adjuster is handling claims in accordance with company’s claims handling best practices and claims philosophy.
• Properly identifies files appropriate for claims committee, coverage counsel or subrogation.
• Ensures proper reserves and authorizes claim payments within authority.
• Controls claim and loss costs and adjustment expenses.
• Advances file review reports ensuring sufficient information is provided to support reservice increases above supervisory level.
• Oversees and monitors the workload and performance of the team.
• Guides team through complex work issues and answers questions.
• Routinely meets with team members to monitor business decisions made to ensure compliance with authority levels, good faith claim handling, and regulatory requirements.
• Ensures files are properly documented and monitors claims system productivity metrics.
• Collaborates with team members to establish performance goals and monitors status.
• Conducts performance reviews and provides coaching.
• Interviews, hires, and recommends salary adjustments for team members.
• Resolves disciplinary issues, reviews results, actions plans, and progress.
• Develops team expertise and assists with succession planning, including identifying talent and implementing development plans for critical positions.
• Supports diversity, equity, and inclusion initiatives.
• Fosters an innovative culture, including supporting new ideas and providing guidance on potential changes.
• Develops and fosters excellent customer relations as it relates to complex casualty claims.
• Monitors the customer service metrics and ensure that customer experience levels are being met.
• Collaborates with Underwriting, Marketing, and Claims Liaison to educate agents on EMC products and services to ensure agents and customers receive superior customer experiences and select EMC as their carrier of choice.
• Communicates with agents proactively and anticipates agents’ and insureds’ needs.
• Visits agencies to discuss accounts and losses.
• Collaborates and communicates with management on trends, opportunities and results.
• Develops and markets the claim brand and culture among EMC teams, and prospects in the industry.

Skills

• Bachelor’s degree or equivalent relevant experience
• Ten years of experience in casualty claims adjusting or related experience, including experience with large and complex claims
• Attainment of all applicable state licenses as required
• Prior leadership experience
• Excellent understanding of casualty claims techniques and a current knowledge of various jurisdictions, good faith claims handling requirements and legal environments
• Advanced knowledge of insurance terms and coverages in commercial lines
• Advanced knowledge of negotiation and alternative dispute resolution techniques
• Strong leadership qualities with the ability to motivate staff
• Excellent knowledge of computers and claims systems
• Excellent organizational, written and verbal communication skills
• Excellent ability to gather and analyze a variety of data points to appropriately triage claims handling
• Advanced investigative and problem-solving abilities
• Occasional travel nationwide, valid driver’s license with an acceptable motor vehicle report per company standards will be required if driving
• Insurance designations, such as INS, AIC, and CPCU preferred

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