Also referred to as:
Claims Examinations/Adjustments Manager, Claims Processing Manager, Claims Review and Settlement Manager, Claims Service and Operations Manager
Requirements and Responsibilities
Claims Manager manages the operations of an insurance claims department to ensure timely, accurate, and compliant claims handling. Oversees the investigation, evaluation, negotiation, and settlement of claims to meet operational, financial, and service requirements. Being a Claims Manager develops and enforces procedures, quality controls, and performance metrics to maintain consistency and compliance. Reviews complex or high-exposure claims and provides technical guidance and settlement authority to staff. Additionally, Claims 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 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. To be a Claims 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.
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