Claim Operations Supervisor

  • Church Mutual Insurance Company
  • Merrill, WI, USA
Full time Insurance

Job Description

Accountable for the outcomes produced by direct reports and/or the TPA (Third Party Administrator) and the financial exposure associated with the assigned team's claim volume and responsibilities.  Champion department and change management initiatives.  Supervisor responsibilities to include staffing, training and development, performance management, and workforce planning.
Responsibilities
Supervisor/Manager responsibilities may include some or all of the following:
Staffing needs, to include interviewing and onboarding for new team members.
Onboarding, training, coaching, and development.
Performance management, goal setting, employee engagement, and salary administration.
Workforce management to include: unit equipment, software, space needs, approving time off and overtime usage, and budget recommendations.
Oversee TPA partner, as appropriate, to ensure proper claim handling.
Provide direction and coaching to direct reports and/or TPA to facilitate positive results. Ensure adherence to Claim Best Practice guidelines.
Plan and implement changes to Best Practice guidelines and Service Level agreements.
Work closely with Claim leadership, vendors and stakeholders throughout the Company to identify and document customer/consumer requirements. Devise solutions and communicate those solutions and results to a variety of stakeholders including Executive Leaders.
Provide leadership in driving projects and other initiatives that promote continuous improvement and gain efficiencies within the Claim department.
Evaluate, analyze, and maintain new software as well as updates to existing software and applications.
Plan and onboard new vendor relationships or vendor integrations for Claim.
Recognize and provide awareness to emerging trends that may need to be addressed by Senior Leadership. Recommend actions to mitigate negative trends.
Communicate necessary changes in process, workflow, and procedure to the Claim department outlining the impact and reason for the change.
Monitor the performance of teams, and vendors as appropriate, through the use of claim audits, work product review, and dialogue with direct reports. Assist and support the creation and implementation of audit action plan with suggested goals and training opportunities.  Conduct coaching and mentoring interactions with team members.  Provide meaningful career development guidance to direct reports.
Communicate effectively to team members, peers, business partners, and stakeholders from other internal departments. Champion department initiatives and change management through effective written and verbal communications.  Initiate and implement process and procedural changes effectively to maintain productivity.
Guide strategies for resolving customer concerns, providing oversight to the individual contributor, or responding directly to customer as appropriate. Develop fair solutions to meet the needs of Church Mutual, our affiliates, and our policyholders.
Analyze management reports to ensure workloads are consistent with the skill level and experience of team members. Propose staffing solutions that align with unit and department goals and metrics.
Collaborate in the hiring process to ensure selection of qualified candidates for open positions. Deliver a positive onboarding/training experience through partnership with Learning and Development.
Qualifications
Bachelor's degree is preferred. Equivalent education and/or insurance experience may be considered in lieu of degree.
Completion of either AIC, AIM, or SCLA designations is not required, but is desirable and may be required as part of ongoing development.
Minimum of three years of commercial lines claims experience, or comparable work in an operations environment is required.
Knowledge of work-processing procedures, continuous improvement methodology and concepts like six-sigma and Agile, to recognize potential improvement opportunities is desired.
Knowledge of the concepts of best practices, standard work development, value stream analysis, and change management practices is strongly desired.
Evidence of strong leadership skills.
Possess understanding of claim handling standards and strong knowledge of state and other regulatory requirements.
Effective verbal and written communication skills.
Ability to effectively listen to others and collaboratively share ideas throughout all levels of the organization.
Effective interpersonal skills in order to coach and lead individuals to their full potential to meet company objectives, and to work cohesively in a team environment.
Ability to develop a comprehensive and thorough understanding of the claims system(s) and other claim related applications and software.
Strong judgment, decision-making skills, and organizational abilities.
Ability to approach problem-solving systematically and creatively.
Knowledge and ability to work with various systems, software, applications, programs, and databases.
Church Mutual is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.