Supervises activities in the claims department.
Leads the examination of personal and property and casualty insurance claims based on policy provisions, appraisal, and verifiable damage. Interacts with claimants and oversees the review of records and documentation to ascertain insurance coverage. Supervises settlement negotiations within authorized limits and escalates claims exceeding authorization. May conduct team training.
| Job Title | Job Description | |
|---|---|---|
| 1 | Vice President of Claims | The Vice President of Claims is responsible for managing and implementing claims programs for all lines of insurance. Plans and directs all aspects of an organization's insurance claims function. Being a Vice President of Claims develops procedures and policies to enhance and improve the processing, investigation, and settlement of claims. Directs the review and settlement of complex or high dollar claims. In addition, Vice President of Claims ensures legal examinations are made when appropriate. Requires a bachelor's degree. Typically reports to top management. The Vice President of Claims manages a departmental function within a broader corporate function. Develops major goals to support broad functional objectives. Approves policies developed within various sub-functions and departments. Comprehensive knowledge of the overall departmental function. Working as a Vice President of Claims typically requires 8+ years of managerial experience. |
| 2 | Insurance Underwriter I | The Insurance Underwriter I utilizes underwriting guidelines, rules, standards, and levels of authority to accept, reject, or mitigate risk for applications and determine appropriate premiums, limits, and coverages. Reviews and analyzes risk characteristics on insurance applications, renewals, and change requests. Being a Insurance Underwriter I ensures that underwriting activities comply with all industry and governmental regulations. Calculates renewal rates. In addition, Insurance Underwriter I may coordinate with field agents to collect or clarify information or decisions. Typically requires a bachelor's degree or equivalent. Typically reports to a supervisor or manager. Being a Insurance Underwriter I work is closely managed. Works on projects/matters of limited complexity in a support role. Working as a Insurance Underwriter I typically requires 0-2 years of related experience. |
| 3 | Electrician - Apprentice | The Electrician - Apprentice ensures all work performed meets required safety codes and is properly inspected. Inspects, repairs, installs, and maintains electrical systems, machinery, and equipment. Being an Electrician - Apprentice typically requires a high school diploma or its equivalent. Uses a variety of tools and equipment, such as power construction equipment, measuring devices, power tools, and testing equipment. In addition, Electrician - Apprentice typically reports to a supervisor or manager. Typically requires an Electrician's license from the state. Being an Electrician - Apprentice gains or has attained full proficiency in a specific area of discipline. Works under moderate supervision. Working as an Electrician - Apprentice typically requires 1-3 years of related experience or may have 0 years of experience plus an associates degree, or additional training, or certification. |
| 4 | Claims Payment Clerk I | The Claims Payment Clerk I inputs claim information into system for processing. Reviews insurance claim forms and supporting documents for completeness and accuracy and obtains missing information as necessary. Being a Claims Payment Clerk I calculates settlement amounts according to guidelines. Verifies coverage eligibility. In addition, Claims Payment Clerk I processes routine claim payments. Requires a high school diploma or equivalent. Typically reports to a supervisor. Being a Claims Payment Clerk I works under the close direction of senior personnel in the functional area. Possesses a moderate understanding of general aspects of the job. May require 0-1 year of general work experience. |
| 5 | Claims Examinations/Adjustments Manager | The Claims Examinations/Adjustments Manager oversees the investigation, evaluation, negotiation, and settlement of claims to meet operational, financial, and service requirements. Manages the operations of an insurance claims department to ensure timely, accurate, and compliant claims handling. Being a Claims Examinations/Adjustments Manager reviews complex or high-exposure claims and provides technical guidance and settlement authority to staff. Develops and enforces procedures, quality controls, and performance metrics to maintain consistency and compliance. In addition, Claims Examinations/Adjustments Manager monitors caseloads, productivity, and reserve accuracy to meet departmental goals. Ensures compliance with applicable regulations, company policies, and customer service expectations. Requires a bachelor's degree. Typically reports to a director. The Claims Examinations/Adjustments Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Working as a Claims Examinations/Adjustments Manager typically requires 5 years experience in the related area as an individual contributor. 1-3 years supervisory experience may be required. Extensive knowledge of the function and department processes. |
| Skills | Proficiency Level |
|---|---|
| Standard Operating Procedures (SOP) | Level 2 |
| Risk Management | Level 2 |
| Planning and Organizing | Level 1 |