Liability claims manager

Job Details

Job Location: Philadelphia Office - Philadelphia, PA 19107

Position Type: Full Time

Education Level: High School Diploma or GED

Salary Range: $115,000.00 - $145,000.00 Salary

Travel Percentage: 30%

Job Shift: Day

Job Category: Admin - Clerical

POSITION SUMMARY:

Under minimal supervision, manages and directs the activities of a claims unit to ensure high-quality claim handling, client service excellence, and compliance with applicable state laws, regulations, and company policies and procedures.

DUTIES AND RESPONSIBILITIES

• Directly supervises Claims Examiners and Claims Assistants, including monitoring attendance, performance, coaching, performance evaluations, and disciplinary matters.
• Reviews and addresses scheduled claim activities, including initial reviews, periodic reviews, delays, denials, and other claim-related issues.
• Reviews and approves reserve changes, settlements, awards, and payments within authority limits.
• Conducts file reviews to ensure compliance with company policies, client requirements, and applicable laws and regulations.
• Coordinates, conducts, and documents training sessions related to legislative changes, company procedures, and best practices.
• Conducts and documents internal and external educational sessions.
• Ensures appropriate staffing levels are maintained to support workload demands and service expectations.
• Supervises and approves daily check runs and payment registers.
• Responds to claimant, client, and vendor concerns and resolves issues as appropriate.
• Monitors vendor performance and effectiveness to ensure service quality and compliance.
• Ensures client service instructions and account-specific requirements are consistently followed.
• Provides operational coverage for examiner vacancies resulting from vacations, leaves of absence, or open positions.
• Prepares, reviews, and evaluates monthly client reports and management information.
• Facilitates internal, external, and client audits.
• Partners with Corporate Operations, Sales, and Client Services teams in support of RFPs, implementations, and client service initiatives.
• Participates in client claim reviews and stewardship meetings.
• Provides account management support for accounts that do not have an assigned Account Manager.
• Monitors branch expenses and approves invoices and related expenditures in accordance with company guidelines.
• Performs other duties as assigned.

Essential Job Function

Equipment Operated/Used: Computer, calculator, printer, copier, scanner, telephone, and other standard office equipment.

Special Equipment or Clothing: Appropriate business attire as required by company policy.

Qualifications

QUALIFICATIONS REQUIRED:

• Education and Experience: High School Diploma or GED required. Bachelor’s degree in business administration, Risk Management, Insurance, or a related field preferred.
• Five (5) to ten (10) years of progressively responsible claims management or claims handling experience. Equivalent combinations of education and experience may be considered.

Knowledge, Skills, and Abilities:

• Strong technical knowledge of liability claims handling, statutory regulations, and medical terminology.
• Ability to effectively manage multiple priorities, work within a diary system, and meet strict deadlines.
• Strong analytical, problem-solving, and decision-making skills.
• Proficiency in Microsoft Office applications, including Word, Excel, Outlook, and Teams.
• Excellent written and verbal communication skills, including the ability to communicate complex claim matters to clients, claimants, vendors, and staff.
• Demonstrated leadership and employee development skills with the ability to manage individuals with varying levels of experience and expertise.
• Strong interpersonal and relationship-building skills.
• Excellent customer service and client management skills.
• Ability to maintain confidentiality and exercise sound judgment in sensitive situations.

Benefits

Here are some of the benefits you can enjoy in this role:

• Medical, Dental & Vision insurance
• Life & Disability Insurance
• 401(k) plan
• Paid time off
• Paid holidays
• Referral Bonus

Mental and Physical Requirements

MENTAL EFFORT

Reasoning development: Follow one- or two-step instructions; routine, repetitive task. Carry out detail but uninvolved written or verbal instructions; deal with a few concrete variables. Follow written, verbal, or diagrammatic instructions; several concrete variables. Solve practical problems; variety of variables with limited standardization; interpret instructions. Logical or scientific thinking to solve problems; several abstract and concrete variables. Wide range of intellectual and practical problems; comprehend most obscure concepts.

PHYSICAL EFFORT

Physical activity required to perform the job: Sedentary work: Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.