Blue Cross Blue Shield of MichiganBM

Manager, Claims

Blue Cross Blue Shield of Michigan

Salary: 90k-152k USD

United States only
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SUMMARY

The Claims, Manager role is responsible for managing a team of Claim Representatives handling Commercial General Liability, Auto, Auto Dealers, Garage, Trucking and various other casualty lines of business. Responsible for managing and coordinating the claims related processes to serve all fifty states. This responsibility includes leading team members and managing resources to achieve team goals and objectives that support company business goals. Sets annual unit business goals, monitors production and business activity, ensures business process times are met, and establishes roles and responsibilities while maximizing use of employee talent. Assists and monitors team member’s workloads, acts as liaison between team members and other teams or technical staff and establish team goals, procedures, and strategies. This particular position will manage a “Fast Track” team of mostly property damage claims with some minor bodily injury claims. This is a high volume, fast paced claims team. This is a remote position where the manager can work from home anywhere in the U.S., or one of our offices in Arizona, Ohio, Michigan or Kansas.

RESPONSIBILITIES/TASKS

  • Effectively manages the quality review process.
  • Manages a multi-functional unit of Claims professionals and support staff. Evaluates and develops employees to ensure the best utilization of unit talent.
  • Identifies team-staffing needs and takes necessary measures to ensure appropriate levels of service.
  • Consistently monitors workflows to maximize efficiency. Maintains an acceptable level of service and customer satisfaction and retention.
  • Communicates and collaborates with all of the various Accident Fund Company departments/teams with whom the customer may interact or impact through daily processes.
  • Ensure appropriate account management occurs to support Accident Fund business needs.
  • Evaluates training needs, develops training plans and ensures implementation.
  • Develops unit goals, objectives, processes, procedures, and systems.
  • Participates in development of annual departmental budget, monitors budget and identifies budget discrepancies. Research cause of discrepancies and makes recommendations.
  • Ensures efficient and effective use of company resources, evaluates processes and procedures, and develops new procedures.
  • Maintains up-to-date technical knowledge of Claims core functions.
  • Ensures maximum team effectiveness through coordination of team functions/activities and streamlining processes to minimize duplication of efforts and promote team efficiency.
  • Mentor's employees and develops career paths with growth opportunities.
  • Provides guidance and advice when required or necessary and encourage/motivate employees in their daily efforts.
  • Responsibility for balancing workload to optimize the effectiveness of the team.
  • Participates in special projects and serves on committees as needed.
  • Maintains confidentiality.

Supervisory: Directly manages exempt and non-exempt staff. Carries out responsibilities in accordance with company policies and applicable laws. Responsibilities include interviewing, selecting and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints; and resolving problems.

Performs other related duties which may not be specifically listed in the position description, but which are within the general occupational series and responsibility level typically associated with the employee’s class of work.

EMPLOYMENT QUALIFICATIONS:

EDUCATION

  • Bachelor’s degree in insurance, business or a related field.
  • Progress towards, or completion of, industry-recognized professional designation preferred.
  • Combination of relevant education and experience may be considered in lieu of degree.

EXPERIENCE

  • Seven years of experience in an insurance organization with demonstrated technical knowledge in claims management.
  • Three years of previous leadership experience required.

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED

  • Customer service focused Claims Manager who demonstrates knowledge and understanding of Commercial General Liability, Auto, Auto Dealers, Garage, Trucking and other casualty lines of business.
  • Supervise and manage a team of Claim Representatives.
  • Acts as a technical expert in handling complaints and other escalated issues from internal and external customers.
  • Supervise and manage designated coverage issues.
  • Review and approve coverage determination letters.
  • Assist in training Claims Representatives in the handling of designated issues involving liability, investigation, value, civil procedure and State and Federal law.
  • Provide guidance to Claims Representatives on their negotiations, mediations, arbitrations and settlement procedures as assigned.
  • Conduct audits of claim files to ensure best practices.
  • Knowledge of team-building and employee motivation theories with the ability to effectively manage multi-functional employee teams.
  • Demonstrated leadership abilities.
  • Demonstrated technical knowledge of insurance administration, claims management, or relevant insurance expertise.
  • Ability to work with and empower others on a collaborative basis to ensure success of unit team.
  • Excellent oral and written communication skills.
  • Ability to effectively exchange information, in verbal or written form, by sharing ideas, reporting facts and other information, responding to questions and employing active listening techniques.
  • Knowledge of insurance and underwriting techniques, agency and policyholder needs.
  • Ability to effectively present budgetary and/or cost information, and respond to questions as appropriate.
  • Ability to establish workflows, manage multiple projects, and meet necessary deadlines.
  • Ability to maintain confidentiality.
  • Ability and proficiency in the use of computers and company standard software specific to position.
  • Ability to perform other assignments at locations outside the office.

WORKING CONDITIONS:

Work is performed in an office setting with no unusual hazards.

The qualifications listed above are intended to represent the minimal skills and experience levels associated with performing the duties and responsibilities contained in this position description. The qualifications should not be viewed as absolute standards, but as general guidelines that should be considered with other position-related criteria.

Pay Range - Actual compensation decision relies on the consideration of internal equity, candidate’s skills and professional experience, geographic location, market, and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $90,400 and $151,500.

We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.

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About the job

Apply before

Jun 16, 2024

Posted on

Apr 17, 2024

Job type

Full Time

Experience level

Mid-level

Salary

Salary: 90k-152k USD

Location requirements

Hiring timezones

United States +/- 0 hours

About Blue Cross Blue Shield of Michigan

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