Claims Operations Manager

The Claims Operations Manager is responsible for managing all non-technical aspects of operations for the Claims organization at Fortegra.

This position will maintain policies and procedures for the Claims Department, monitor the quality and efficiency of claims service, and ensure compliance with industry standards and regulations.

The successful candidate will be a strategic thinker and problem solver with exceptional interpersonal, communication, and leadership skills.

Minimum Qualifications :

• Degree in Business Administration, Management or closely related field or equivalent work experience.
• 7 to 10 years of professional experience in Specialty (P&C) claims.
• At least 3 years of management and supervision of claims staff preferred.

Primary Job Functions :

• Execute departmental quality assurance program.
• Provide management reporting on key performance indicators and implementation of operational metrics.
• Make effective use of data analytics to provide input for management decision making.
• Continuously improve claims processing and data workflows, reducing turnaround time, and enhancing accuracy.
• Establish and maintain relationships with key stakeholders, external customers, and industry partners.
• Provide operational oversight for TPAs to ensure compliance with service agreements.
• Validate staffing levels and anticipate workforce demands.
• Ensure compliance with company and industry regulations, policies and guidelines.
• Develop and maintain interdepartmental relationships and resolve operational and procedural difficulties / issues with management, work teams, and customers as necessary.
• Maintain panel counsel list and other vendor information.
• Oversee SIU and ensure regulatory compliance.
• Coordinate CLE training and licensing.
• Drive culture of continuous improvement.
• Plan, recommend, and promote policies that will support the company and department objectives.

The above cited duties and responsibilities describe the general nature and level of work performed by people assigned to the job.

They are not intended to be an exhaustive list of all the duties and responsibilities that an incumbent may be expected or asked to perform.

Skills & Competencies Required :

• Detail-oriented with demonstrated ability to self-direct, prioritize work, and meet deadlines.
• Demonstrated business acumen, including problem-solving skills, data analysis, critical thinking, business analysis, and organizational skills.
• Strong project management skills to advance teams and initiatives.
• High level of emotional intelligence, influencing skills, and communication skills to enable collaboration with a variety of key stakeholders including senior leadership.
• Ability to effectively create a collaborative, team-oriented environment including mentoring and motivating team members to be accountable.
• Ability to develop and implement effective operational strategies to improve customer service and efficiency.

Additional Information :

Full benefit package including medical, dental, life, vision, company paid short / long term disability, 401(k), tuition assistance and more.