Mgr Service Claims

Our Claims team is currently seeking a Manager - Service Claims.

This is a full-time, exempt role with a hybrid work schedule (two days in the office) in our Richmond, VA office.

POSITION OVERVIEW: 

The Manager Service Claims is responsible for the daily oversight of the claims service handling team, leading employees to foster a highly engaged, high-performing workforce aligned with the organization’s strategic goals. This role ensures effective front-line adjustment of claims while demonstrating expertise in performance management, communication, decision-making, relationship building, and customer service. The manager proactively assesses current and future resource needs, providing mentorship and guidance to support continuous development and operational excellence.

IN THIS ROLE, YOU WILL: 

• Oversees the day-to-day operations of a claims service handling team including the investigation and evaluation of claims.
• Monitor and assess employee performance through spot checks (e.g., phone listening, file reviews) and data tools (e.g., Power BI, flight decks, trend analysis); provide feedback and implement improvement plans to ensure thorough and efficient investigations.
• Develop and implement continuous improvement initiatives to enhance the quality and consistency of the investigative process.
• Create and enforce protocols to detect and prevent fraudulent claims; review claims with potential fraud.
• Apply technical knowledge (e.g., comparative negligence laws across all 50 states), to support employees in their investigations and evaluations. Direct day-to-day operations including tracking measures, analyzing reports, and reinforcing goals.
• Handle escalated complaints or disputes, working to resolve issues amicably and maintain positive relationships with clients.
• May utilize technology and talent management to increase efficiency and scalability in claims handling; analyze claims data to identify trends, areas for improvement, and opportunities for cost savings.
• Evaluate and approve reserve and settlements outside of individual authorities.
• Monitor and control expenses related to claim handling activities; review and approve settlement proposals prepared by claims handlers to ensure they are reasonable and justifiable.
• Support and mentor others and demonstrate proficiency in contractual indemnification.
• Lead negotiation in contested claims, employing advanced negotiation strategies for optimal outcomes for claims within scope of unit, balancing indemnity and customer satisfaction.
• Ensure compliance with all claim handling guidelines and policies.
• Provide regular updates and reports to senior management and other departments; adapt communication styles to audience (e.g., director versus peer).

WHAT YOU NEED TO APPLY: 

• Bachelor’s degree; Generally, 5-7 years related claims experience; supervisory experience preferred but not required
• Skilled in Microsoft Office Suite (Word, Excel), claims management systems, and data analysis tools for documentation, reporting, and process optimization.
• Ability to cultivate a high-performing team through mentoring, coaching, and fostering a positive work environment.
• Skilled in leading negotiations with stakeholders to achieve fair outcomes while maintaining policy and financial integrity.
• Capable of resolving complex or sensitive disputes with empathy and adherence to organizational guidelines.
• Effective verbal and written communicator across diverse audiences and situations; able to draft factual, objective work products.
• Proficient in developing others’ negotiation, communication, and organizational skills.
• Highly organized with the ability to manage complex projects and develop scalable organizational strategies.
• Expert in developing empathetic customer service strategies and delivering exceptional service.
• Recognized authority in insurance principles, policy coverage, legal liability, and jurisdictional requirements.
• Expert in managing legal and reputational risks; ensures compliance with regulatory standards.
• Makes informed, independent decisions within authority, evaluating risks and financial implications.
• Understands how to align team performance with broader business goals and resource planning.

Core Capabilities:

• Analytical Reasoning: The ability to identify problems, understand your impact, gather input and data, and develop an effective solution.
• Customer Centricity: Makes customers/clients and their needs a primary focus of one’s actions; shows interest in and understanding of the needs and expectations of internal and external customers; gains customer trust and respect; meets or exceeds customer expectations.
• Digital Fluency: Effectively uses digital tools and technology appropriately to find, evaluate, create, and communicate information understands how to navigate digital platforms, use software applications, and leverage technology for productivity and communication purposes.
• Persuasion and Influence: Uses appropriate interpersonal skills and techniques to gain acceptance for ideas or solutions; uses influencing strategies to gain genuine agreements; seeks to persuade rather than force solutions or impose decisions or regulations.
• Professional Insurance Acumen: Demonstrates a deepening understanding of the insurance industry and the ability to apply specialized technical skills to address complex challenges, adapt to industry trends, and drive value for the organization.
• Planning and Execution: Plans, prioritizes and manages resources and time effectively to achieve specific goals or deadlines.