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Crum & Forster Insurance

Insures businesses against standard and specialty risks

Claims Program Manager

InsuranceConfirmed live in the last 24 hours
Full-timeRemote in USA

About the Job

Requirements

  • A bachelor's degree from an accredited university or institution, or equivalent experience.
  • At least 6 years of relevant Special Risk, Travel, and Travel Medical experience.
  • Strong PC skills, including Excel, Word, Outlook, and PowerPoint.
  • Ability to travel 20% of the time.
  • Ability to establish strong rapport with customers and team members.
  • Demonstrated high level of service delivery, with a focus on customer satisfaction and issue resolution.
  • Strong analytical and problem-solving skills, with the ability to identify and implement process improvements.
  • Excellent attention to detail and organizational skills, with the ability to manage multiple tasks in a fast-paced environment.
  • Ability to work independently and collaboratively within a team.
  • Excellent written and verbal communication skills, including the ability to present complex information clearly.
  • Commitment to personal accountability and continuous improvement.

Responsibilities

  • Act as an audit coordinator by scheduling, coordinating, and monitoring annual audits.
  • Conduct first-level review of required reports drafted by Program Management Team members.
  • Oversee Program Team member functions, including managing a diverse portfolio of products and administrators on an ongoing basis.
  • Serve as a liaison to administrative, operations, and underwriting areas of the company.
  • Address issues with distressed customers professionally and sensitively.
  • Participate in team members' client meetings and address all open issues at least monthly.
  • Address technical issues and coordinate with the IT team to seek resolutions as needed.
  • Assign or assist with onboarding new clients as needed.
  • Establish long-term customer relationships through prompt and courteous service.
  • Assist with due diligence of new program administration business, including onsite reviews and assessments, and provide management with operational assessments of prospective partners.
  • Assist with annual reviews of administrators to ensure compliance with company requirements and identify process gaps or improvement areas at the administrator and company levels.
  • Monitor claims activity at least quarterly to identify outliers.
  • Identify processing, system, and operational issues within client or company operations to ensure claims are paid consistently with policy terms.
  • Prepare monthly reporting packages, including inventory reporting, first-level TPA customer service and turnaround statistics, and referral analysis for review by senior management.
  • Analyze claims-related litigation and regulatory inquiries monthly to identify trends and exposure.
  • Analyze claims referral logs at least quarterly to identify trends and recommend authority-level adjustments as necessary.
  • Refer small claims litigation to the Legal team and assist as necessary.
  • Review attorney correspondence and coordinate responses with the administrator.
  • Assist Compliance with reviews of claims-related regulatory inquiries.
  • Draft initial internal Claims Best Practices documents covering standards, including C&F and regulatory standards, procedures, and workflows.
  • Review and update Claims Best Practices at least quarterly.
  • Oversee the Program Management Team's review of TPA Best Practices to ensure claims administrators are informed of and adhere to applicable state unfair claims practices laws.
  • Continue developing product knowledge on the Program Management Team.
  • Assist in developing the Program Management Team's ability to think beyond the immediate claims audit.
  • Use actual situations, such as distressed administrators, as educational and development tools for Program Management Team members.
  • Perform other duties as assigned.

Desired Qualifications

  • Experience with specialty products such as Employer Stop Loss, Travel, Short Term Medical, Medical Travel, Workers Compensation, and/or Occupational Accident.

About the Company

Crum & Forster Insurance

Insures businesses against standard and specialty risks

Crum & Forster insures businesses and individuals against property damage, legal liability, accidents and health costs. It sells standard commercial coverage alongside specialty policies for risks that need more tailored terms, using a national network of independent agents, brokers and wholesalers to reach buyers. Its insurers collect premiums in exchange for accepting covered risks, while Travel Insured International, part of its accident and health business, sells travel protection to both consumers and agency partners of all sizes. Founded in 1822 and headquartered in Morristown, New Jersey, the company is part of Fairfax Financial Holdings.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Morristown, NJ
Founded
1822

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