JOB SUMMARY:

The Claims Manager is responsible for the strategic oversight, evaluation, and resolution of insurance and liability claims on behalf of the organization. This role ensures timely, fair, and consistent claim outcomes while minimizing financial exposure and operational risk. The Claims Manager maintains compliance with all applicable laws, regulations, internal policies, and contractual obligations, and serves as a trusted advisor to leadership on claim-related matters.

PRIMARY DUTIES AND RESPONSIBILITIES:

• Manage the full life cycle of claims, including Workers’ Compensation, General Liability, Auto, Property, and Professional Liability, as applicable.
• Ensure timely claim reporting, thorough investigations, accurate exposure evaluations, and effective resolution strategies.
• Maintain compliance with legal, regulatory, and contractual requirements across all claim types.
• Coordinate the collection and preparation of documentation required for interrogatories, mediations, hearings, and trials.
• Provide leadership and oversight of Third-Party Administrators to ensure adherence to service level agreements and performance standards.
• Develop, implement, and maintain claims policies, procedures, and best practices to improve efficiency and consistency.
• Train, mentor, and support internal team members on claims processes, workflows, and the full claim life cycle.
• Review claim reserves, indemnity payments, and litigation expenses to ensure accuracy and financial integrity.
• Evaluate settlement demands and resolution strategies in collaboration with TPAs and defense counsel.
• Identify opportunities for cost containment, recovery, and subrogation, and implement proactive risk mitigation strategies.
• Manage relationships with insurers, TPAs, defense counsel, medical providers, and other external vendors.
• Communicate claim status, financial exposure, trends, and outcomes to senior leadership and key stakeholders.
• Evaluate vendor performance and recommend improvements to enhance service quality, compliance, and cost effectiveness.
• Monitor claim trends, key performance indicators, and loss drivers across all lines of coverage.
• Prepare regular and ad hoc reports for executive leadership to support informed decision-making.
• Leverage data analytics to identify patterns, emerging risks, and opportunities for loss prevention.
• Ensure accurate and complete claim documentation is maintained within RMIS and other claims management systems.

REQUIREMENTS:

• High School Diploma or GED
• 3 – 5 years of experience in DOT/fleet management required
• 3-5 years of claims experience (Workers Compensation, Auto liability, and General Liability)
• Knowledge of all aspects of fleet/DOT compliance and related state/federal regulations required, including driver qualification files, driver logs, vehicle compliance, permits, tracking of all vehicles, etc.
• Strong organizational skills and attention to detail; proficiency in MS Office
• Ability to handle confidential material and understand compliance regulations.
• Ability to multi-task, follow directions, work independently, be open to change, and work under pressure
• Excellent written and oral communication skills
• Ability to communicate effectively with various levels of staff.