What are the responsibilities and job description for the District Claims Manager position at Texas Farm Bureau Mutual Insurance Company?
Job Responsibilities:
This position is responsible for maintaining prompt, fair, and efficient claims service in their assigned area by providing direction and leadership to the field adjusting staff. This position is also responsible for monitoring and controlling files to ensure a successful conclusion.
MAJOR RESPONSIBILITIES AND AUTHORITY
Review all claims and direct investigation, report status, and determine if files should be settled.
Ensure that Claims Standards and Texas Department of Insurance requirements are followed on all claims.
Provide advice and fully support all functions of the claims department including subrogation, physical damage, and property.
Investigate, develop, and submit coverage questions and Errors and Omission losses.
Promote professional self-development for the assigned Claims Representatives and Claims Assistants.
Assist district personnel in the interpretation and application of policy language.
Set reasonable goals regarding performance, customer satisfaction, expenses, and education for Claims Representatives and other district personnel.
Establish and maintain proper reserves on all files in assigned district.
Answer calls and complaints promptly and respond to Texas Department of Insurance inquiries in a timely manner or as required by the Texas Department of Insurance.
Conduct legal research as necessary or requested by the appropriate Regional Claims Manager, Director of Claims, or VP Claims.
Initiate negotiation and settlement on files as needed.
Secure outside investigators, attorneys, and experts from the approved lists when needed.
Monitor and control loss adjustment expenses within assigned district.
Review monthly expense reports, telephone bills, and other miscellaneous expense reports for Claims Representatives within the assigned district.
Inventory and inspect company equipment assigned to district personnel in order to ensure that all equipment is being properly used and maintained.
Review and forward claim reports to Underwriting and instruct staff to complete underwriting reports when they have neglected to do so.
Monitor the territory assignments and redistribute assignments as necessary to ensure equitable workloads, and to ensure policyholders are receiving proper customer service.
Plan and conduct a minimum of four district meetings per year.
Attend depositions, mediations, and trials when requested by Litigation Department and encourage Claims Representatives to attend when possible.
Evaluate the performance of Claims Representatives and Claims Assistants, recommend salary changes, and provide constructive feedback and instruction that will enable staff to advance their performance.
Report claims to Reinsurers in accordance with guidelines and provide proper updates.
Attend and participate in claim review meetings.
Ensure that all state-mandated requirements are met.
Resolve personnel issues in a prompt and fair manner, requesting assistance from the Regional Claims Manager and/or Director of Human Resources Department if necessary.
Conclude claims within the limits of the policy and within the standards and procedures.
Hire, train, develop, and terminate personnel as appropriate.
Properly care for and maintain company equipment including car, cell phone, computer, etc.
Comply with the Certified Fleet Operator requirements of the Company Driving and Safety Policy.
Other duties as assigned.
Job Qualifications:
Four-year degree from an accredited college or university.
Extensive experience in property and casualty claims handling.
Possess qualifications of a Senior Claims Representative.
Acceptable credit rating.
All lines adjuster license from the Texas Department of Insurance, maintained according to the licensing requirements set forth by the State of Texas, or have the ability to obtain such license in a reasonable period.
Thorough understanding of the Claims electronic loss notice process and claims system.
Effective analytical and organizational skills.
Effective knowledge of basic computer applications.
Effective interpersonal and verbal skills including both face to face and over the phone.
Ability to plan, organize, and complete detailed work independently or in a team environment.
Associate in Claims and/or CPCU preferred.
Participation on the Arbitration Panel for a minimum of 10 monthly sessions to include review of at least 100 arbitration files.
Valid Texas driver’s license and driving record at the time of hire which would not place the employee on probation, or disqualify the employee from Certified Fleet Operator Status under the Company Driving and Safety Policy.
Other Job Information (if applicable):
PHYSICAL REQUIREMENTS
Subject to relocation.
Repeated use of PC, telephone, and office machines.
Extended periods of sitting and concentrating.
Occasional bending, twisting, crouching, pulling, pushing, and reaching in an office environment.
Occasional lifting and moving items weighing up to 30 lbs.
WORKING CONDITIONS
Occasional long, irregular work hours.
Travel, including overnight travel, as required.
Work to be conducted in office environment owned or leased by company.
REVISED May 2019
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