Sample Job Description for Claims Examinations/Adjustments Manager
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Claims Examinations/Adjustments Manager Job Overview
Claims Examinations/Adjustments Manager Job Description Sample
Manages the operations of an insurance claims department to meet operational, financial, and service requirements.
JOB LEVEL
M02
EDUCATION/DEGREE
Bachelor's Degree
REPORTS TO
Top Management
Salary Range
BASE 50%
$135,400
TOTAL 50%
$148,900
Job Responsibilities for Claims Examinations/Adjustments Manager
Oversees the intake and processing of insurance claims for personal, property, or casualty loss based on coverage, appraisal, and verifiable damage. Manages appraisal and examination staff and processes. Assures timely and proper disposition of claims based on policy provisions. Recommends and implements best practices to ensure complete and thorough claim settlements, legal reviews, and investigations following company policies and insurance industry regulations. Determines the value of settlements for escalated claims. Manages negotiations of settlements and administration of claims in litigation.
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View Job Description Templates of Similar Jobs
| 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 | 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. |
| 3 | Claims Payment Clerk II | The Claims Payment Clerk II 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 II calculates settlement amounts according to guidelines. Verifies coverage eligibility. In addition, Claims Payment Clerk II processes routine claim payments. Requires a high school diploma or equivalent. Typically reports to a supervisor. Being a Claims Payment Clerk II works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. Working as a Claims Payment Clerk II typically requires 1-3 years of related experience, or may need 0 years of experience with additional specialized training and/or certification. |
| 4 | Claims Service and Operations Director | The Claims Service and Operations Director provides guidance and sets policies on insurance claims for personal, property, or casualty loss based on coverage, appraisal, and verifiable damage. Directs and oversees the operations of an insurance claims department to meet operation, financial, and service requirements. Being a Claims Service and Operations Director keeps abreast of any changes to legislation and regulations which pertain to insurance claims. Responsible for the strategic processing and payment of claims. In addition, Claims Service and Operations Director provides guidance to subordinates on the most complex claims. Requires a bachelor's degree. Typically reports to top management. The Claims Service and Operations Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Working as a Claims Service and Operations Director typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. |
| 5 | Warranty Claims Manager | The Warranty Claims Manager provides oversight to warranty technicians and the processing of warranty claims. Oversees the warranty process. Being a Warranty Claims Manager typically reports to a head of a unit/department. Typically requires a bachelor's degree in a related area. Working as a Warranty Claims Manager typically requires 3-5 years of related experience. Has gained proficiency in multiple competencies relevant to the job. Works independently within established procedures associated with the specific job function. |
Claims Examinations/Adjustments Manager Skills & Proficiency Level
| Skills | Proficiency Level |
|---|---|
| Standard Operating Procedures (SOP) | Level 3 |
| Budgeting | Level 2 |
| Risk Management | Level 3 |
