Risk Management Claims Manager

Risk Management Claims Manager

Generic Position Summary

As a member of the professional staff, contributes specialized knowledge and skill in a discipline (e.g. Accounting, Finance, Human Resources, Information Technology, Operations Planning & Support, Sales & Marketing) area to support team and/or department business objectives. Generally, works under limited supervision, but within established guidelines, producing and analyzing more complex business information to assist in the decision-making process.

Specific Job Summary

The Manager, Risk Management-Claims (Workers’ Compensation) is responsible for the oversight of low-level workers’ compensation claims. In addition, the Manager is responsible for the production, analysis and distribution of claims data which measure the value of the claims oversight program.

This includes initiating, monitoring, and measuring the benefit of claims reporting and cost containment programs.

Specific Expected Contributions

Manage workers’ compensation and other employment related claims globally and primary responsibility for settlement approval and reserve concurrence up to $75,000.

Review adequacy of reserve and help develop disposition strategies.

Responsible for providing technical guidance in the investigation, reserving, and disposition of claims.

Manage and resolve issues with subpoenas, request for production, answers to interrogatories.

Work with the Safety & Security team to identify claims trends and coordinating investigations and develop related executive level reporting.

After conducting a thorough claims review, provide concurrence or rejections of denials.

Monitor the work product of dedicated adjuster teams.

Develop action plans to guide claims to the best possible resolution.

Lead quarterly claims reviews.

Provide guidance, recommendations, or direction to dedicated units of adjusters.

Author a quarterly Lessons from Losses to be distributed to Operations and Executive Leadership

Create presentations and provide training to operations to assist our loss control efforts.

Assist Insurance team with potentially high-risk business case reviews and provide support and guidance as needed.

Partner with Human Resources and Resort Operations to support Return-to-Work program.

Provide the law department/litigation group support and guidance as needed for insured claims.

• Special projects as needed
• Specific Candidate Profile (the education, experience, skills, and attributes that are important for this position)
• Education requirements

Four-year degree from an accredited college strongly preferred.

AIC, ARM, CPCU preferred and/or professional claims training from an insurance company of recognized responsibility.

• Experience level
• Minimum of 5 (five) - 7 (seven) years claims adjusting/oversight experience
• Preferred certifications

AIC, AIC-M, ARM, CPCU preferred and/or professional claims training from an insurance company of recognized responsibility.