Complex Casualty Claims Manager

About the Role

The success of this role is measured by the ability to drive strong outcomes on high-exposure cases, ensure accurate reserving, control costs, and maintain compliance with regulatory requirements. It also involves coaching and developing team members, enhancing customer experience, and strengthening relationships with agents and insureds. As a leader in this capacity, you will be expected to stay abreast of industry trends, legal environments, and emerging issues in casualty claims, adapting strategies as necessary to stay ahead.

Given the remote nature of this position, effective communication, adaptability, and the ability to work independently are essential. EMC Insurance Companies prides itself on being a caring leader, close partner, and responsive expert, and this role embodies those values, contributing to the company's mission to make a positive impact.

What You Will Do

• Lead a team of complex casualty claims adjusters, providing strategic guidance on coverage, liability, valuation, and resolution strategies.
• Oversee the review of all assigned claim files to ensure complete fact gathering and identify gaps in information.
• Assign claims to adjusters based on their expertise, ensuring the right skillset is applied to each case.
• Advise team members on coverage, liability, compensability, valuation, and resolution strategies, ensuring alignment with company policies and industry best practices.
• Review and approve reservation of rights and denial letters, ensuring they are legally sound and communicated effectively to stakeholders.
• Select and manage defense counsel, monitor litigated matters, and ensure that legal strategies are aligned with claim objectives.
• Ensure accurate and timely reserves, aligned with company guidelines, and authorize payments within your authority.
• Enforce best practices, claims philosophy, and proper file documentation, conducting regular file reviews to ensure compliance.
• Identify files that require review by the claims committee, coverage counsel, or subrogation opportunities, escalating as necessary.
• Control loss costs and adjustment expenses, ensuring strong file review reporting and monitoring team workload, productivity, and performance metrics.
• Coach team members, resolve complex issues, and ensure regulatory and authority compliance, setting performance goals and conducting regular reviews.
• Hire, discipline, and support talent growth, fostering a culture of diversity, equity, and inclusion (DEI) and innovation within the team.
• Build strong relationships with agents and customers, ensuring service standards are met, and proactively communicate with agents/insureds to review accounts and losses.

What We Are Looking For

• Bachelor's degree or equivalent relevant experience in a field related to insurance, law, or business administration.
• At least ten years of experience in casualty claims adjusting or a related field, with a focus on large and complex claims.
• Attainment of all applicable state licenses as required for the role.
• Prior leadership experience, with a proven track record of managing high-performing teams.
• Insurance designations such as INS, AIC, and CPCU are preferred, demonstrating advanced knowledge and commitment to the field.
• Excellent understanding of casualty claims techniques, current knowledge of various jurisdictions, and good faith claims handling requirements.
• Advanced knowledge of insurance terms and coverages in commercial lines, negotiation, and alternative dispute resolution techniques.
• Strong leadership qualities with the ability to motivate staff, excellent knowledge of computers and claims systems, and excellent organizational, written, and verbal communication skills.

Nice to Have

• Experience with claims management software and systems, facilitating efficient claims handling and data analysis.
• A background in law or a related field, providing a deeper understanding of legal principles and practices.
• Certification in mediation or arbitration, enhancing negotiation and conflict resolution skills.
• Experience in managing remote teams, with strategies for engagement, productivity, and performance management.

Benefits and Perks

• Competitive salary, reflecting the importance of this role and the value it brings to the organization.
• Comprehensive health insurance, including medical, dental, and vision coverage, supporting the well-being of you and your family.
• Generous paid time off (PTO) policy, allowing for work-life balance and personal renewal.
• 401(k) retirement plan with company match, helping you plan for your future.
• Remote work stipend, supporting your home office setup and ongoing remote work needs.
• Professional development opportunities, including training, workshops, and conferences, to enhance your skills and stay current in the industry.
• Access to cutting-edge technology and tools, facilitating efficient work and innovation.
• Collaborative and dynamic work environment, even in a remote setting, with a team that values teamwork, diversity, and inclusivity.

• When applying, ensure your resume and cover letter highlight your leadership experience, claims handling expertise, and knowledge of insurance principles.
• Prepare to discuss specific examples of complex claims you've managed, including strategies used and outcomes achieved.
• Familiarize yourself with EMC Insurance Companies' values and mission, demonstrating how your professional goals and values align with theirs.
• Develop a portfolio or be prepared to share examples of your work, such as reports, analyses, or process improvements you've implemented.
• Be ready to ask insightful questions during the interview, such as inquiries about the team's dynamics, the company culture, and opportunities for growth and development.
• Consider negotiating your salary based on industry standards and your experience, and don't hesitate to ask about benefits and perks that are important to you.