Claims Manager manages the operations of an insurance claims department to meet operational, financial, and service requirements. Oversees the intake and processing of insurance claims for personal, property, or casualty loss based on coverage, appraisal, and verifiable damage. Being a Claims Manager manages appraisal and examination staff and processes. Assures timely and proper disposition of claims based on policy provisions. Additionally, Claims Manager 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. Typically 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. (Copyright 2024 Salary.com)
POSITION PURPOSE:
Responsible for the day-to-day delivery of individual support program services to assigned case load in accordance with Federal, State, and facility codes, regulations, guidelines and expectations.
ESSENTIAL FUNCTIONS OF POSITION:
EDUCATION / REQUIREMENTS:
Is one of the following: A doctor of medicine osteopathy, a registered nurse, an individual who holds at least a bachelor’s degree in a professional category specified in the Federal regulation 483.430 paragraph (b)(5) or designated as a human services professional that has at least a bachelor’s degree in a human services field (including, but not limited to: sociology, special education, rehabilitation counseling, and psychology).
At least one year’s experience working with intellectual disabilities or other developmental disabilities.
When State licensure and/or certification is required for the professional degree held by the QIDP, the license must be current and unencumbered.