Claims Manager Job Description [Updated for 2025]

In the fast-paced world of insurance, the role of a Claims Manager has never been more critical.

As the industry evolves, the demand for skilled professionals who can effectively manage, evaluate, and settle claims only grows stronger.

But let’s delve deeper: What’s truly expected from a Claims Manager?

Whether you are:

• A job seeker trying to understand the core responsibilities of this role,
• A hiring manager looking to outline the perfect candidate,
• Or simply intrigued by the intricacies of claim management,

You’re in the right place.

Today, we present a comprehensive Claims Manager job description template, designed for effortless posting on job boards or career sites.

Let’s dive right into it.

Claims Manager Duties and Responsibilities

Claims Managers oversee the insurance claims department within a company, ensuring that claims are processed accurately and efficiently.

They perform both administrative and managerial duties, and their expertise is crucial in making decisions about the company’s claim procedures and policies.

Their daily duties and responsibilities include:

• Manage and oversee the daily operations of the claims department
• Review and analyze insurance claims to ensure they are valid and that the settlement is fair
• Implement procedures to improve the efficiency of claims processing and settlement
• Coordinate with insurance adjusters, investigators, and claimants to get information regarding insurance claims
• Ensure compliance with state and federal regulations regarding insurance claims
• Establish and implement claims handling and resolution strategies
• Provide customer service by answering claim-related questions and resolving disputes
• Provide claims data reports to senior management and stakeholders
• Train and mentor claims adjusters and other staff in the claims department
• Monitor and manage claims reserve and settlement expenses
• Participate in audits and reviews of the claims department

 

Claims Manager Job Description Template

Job Brief

We are seeking a knowledgeable and experienced Claims Manager to oversee our claims department.

The Claims Manager will be responsible for managing and ensuring efficient and timely processing of claims.

This involves reviewing and analyzing claims, managing the claims team, and improving the claims process to enhance customer satisfaction and cost management.

 

Responsibilities

• Manage and monitor claims team to ensure prompt and accurate claims processing
• Develop and implement claim procedures to ensure efficiency and accuracy
• Review and analyze claim reports and make decisions on appeals and disputes
• Provide technical expertise to the claims team
• Liaise with insurance adjusters and investigators to manage claims
• Train and mentor claims staff to ensure quality and consistency
• Identify trends and patterns in claims for management review
• Oversee and ensure compliance with state and federal regulations
• Work closely with other departments to ensure a cohesive approach to claim handling

 

Qualifications

• Proven work experience as a Claims Manager or similar role in the Insurance industry
• Strong knowledge of insurance claims, procedures, and policies
• Excellent leadership and team management skills
• Strong analytical and problem-solving abilities
• Proficiency in claim management software and databases
• Outstanding communication and negotiation skills
• BSc degree in Business Administration, Insurance, or relevant field

 

Benefits

• 401(k)
• Health insurance
• Dental insurance
• Retirement plan
• Paid time off
• Professional development opportunities

 

Additional Information

• Job Title: Claims Manager
• Work Environment: Office setting with some travel may be required for meetings or site visits.
• Reporting Structure: Reports to the Director of Claims or Chief Operating Officer.
• Salary: Salary is based upon candidate experience and qualifications, as well as market and business considerations.
• Pay Range: $70,000 minimum to $110,000 maximum
• Location: [City, State] (specify the location or indicate if remote)
• Employment Type: Full-time
• Equal Opportunity Statement: We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
• Application Instructions: Please submit your resume and a cover letter outlining your qualifications and experience to [email address or application portal].

 

What Does a Claims Manager Do?

Claims Managers typically work for insurance companies, handling various types of insurance claims, such as home, auto, and life insurance.

They may also be employed by third-party administrators or self-insured companies.

Their main role is to oversee the claims department and ensure that the claims process runs smoothly.

This includes everything from receiving initial claim reports to conducting investigations and negotiating settlements.

Claims Managers work closely with claim adjusters, analysts, and investigators.

They review the work of these professionals, provide training and support, and handle any escalated issues.

They are also responsible for developing and implementing claims policies and procedures.

This involves coordinating with other departments, such as underwriting and legal, to ensure that these policies are in line with company and legal guidelines.

Claims Managers play a critical role in customer service.

They interact with policyholders, answer their questions, address their concerns, and ensure that they are satisfied with the handling of their claims.

In addition, they analyze claims data to identify trends, monitor performance, and develop strategies to improve efficiency and reduce costs.

They may also be involved in handling complex or high-value claims.

 

Claims Manager Qualifications and Skills

A proficient Claims Manager should possess the skills and qualifications that align with your job description, such as:

• Excellent knowledge of insurance contracts, medical terminology, workers compensation laws and other necessary legalities to process claims effectively.
• Strong organizational and multi-tasking skills to manage multiple claims and issues simultaneously while maintaining accuracy and meeting deadlines.
• Exceptional communication and interpersonal skills to liaise with claimants, insurers, and other stakeholders, and to lead and motivate the claims team.
• Investigative skills to determine the validity of an insurance claim, and negotiation skills to decide on the payout for a claim.
• Proficiency in using insurance claims software and digital tools to document, monitor and manage claims.
• Strong analytical skills to evaluate complex information and make well-informed decisions on claims.
• Customer service skills to handle complaints and difficult situations tactfully and professionally.
• Problem-solving skills to address and resolve any issues that may arise during the claims process.
• Ability to keep up-to-date with changes in laws and regulations that affect insurance claims.

 

Claims Manager Experience Requirements

Claims Managers typically need to have a few years of experience, preferably in a claims handling or insurance related role.

This is to help them gain a thorough understanding of claims processes, insurance laws, and policy details.

Entry-level candidates may have 1 to 2 years of experience, often through an internship or part-time role in insurance or claims handling.

These professionals can also gain valuable experience through roles such as Claims Adjuster, Claims Analyst, or Insurance Sales Representative.

Candidates with more than 3 years of experience often develop their technical skills and knowledge in entry-level Claims Manager roles, or as a senior claims handler.

They may also have experience dealing with complex or large-scale claims.

Those with more than 5 years of experience may have some leadership experience in their background, and may be ready for a managerial or team-lead position within the claims department.

They may also be experienced in training and mentoring junior staff, as well as dealing with high-profile clients or cases.

 

Claims Manager Education and Training Requirements

Claims Managers typically hold a bachelor’s degree in business administration, finance, or a related field.

Some companies may require a master’s degree for higher-level positions.

In addition to formal education, Claims Managers often gain experience in insurance, customer service, or a related area before moving into a managerial role.

Further, Claims Managers typically require a thorough understanding of insurance laws and regulations, negotiation tactics, and investigative techniques.

Many employers also prefer or require certification such as the Associate in Claims (AIC) or Certified Claims Professional (CCP).

To stay current with the changing landscape of the insurance industry, continuing education courses or seminars are often recommended or required.

Additionally, strong leadership abilities, excellent communication skills, and a detail-oriented mindset are essential for success in this role.

 

Claims Manager Salary Expectations

A Claims Manager earns an average salary of $81,955 (USD) per year.

However, this income can change based on factors such as experience, level of education, the size of the company, and the region in which they work.

 

Claims Manager Job Description FAQs

What skills does a Claims Manager need?

Claims Managers should have strong leadership skills to effectively manage their team and ensure smooth operation.

They should also have excellent communication skills to interact with different stakeholders, such as claimants, insurance agents, and attorneys.

Attention to detail is important to accurately review claims and avoid any errors.

Additionally, Claims Managers should be proficient in using claims management software and have good analytical abilities to investigate and resolve claims issues.

 

Do Claims Managers need a degree?

Most Claims Managers hold a bachelor’s degree, often in business administration, finance, or a related field.

Prior experience in claims handling or insurance is also typically required.

Some employers may prefer candidates with an advanced degree or professional certification, such as the Associate in Claims (AIC) or Certified Claims Professional (CCP).

 

What should you look for in a Claims Manager resume?

A suitable Claims Manager resume should include a degree in a relevant field and prior experience in claims or insurance.

Look for positions held in claims handling, supervision, or management.

Knowledge and experience in the specific type of insurance your company offers is a plus.

Additionally, any professional certifications or continuing education in insurance or claims management are advantageous.

 

What qualities make a good Claims Manager?

A good Claims Manager should have strong leadership skills to manage a team effectively.

They should be detail-oriented and have excellent problem-solving skills to investigate and resolve claims.

Good communication and interpersonal skills are crucial for maintaining relationships with different stakeholders.

Furthermore, a good Claims Manager should have high ethical standards and integrity to ensure fair and accurate claims settlement.

 

Is it difficult to hire Claims Managers?

Hiring a Claims Manager can be challenging due to the specific skills and experience required for the role.

It’s important to find a candidate with a solid understanding of insurance policies, claim investigation, and claims management.

They also need to have proven leadership capabilities.

Offering competitive salaries and benefits can attract qualified candidates.

 

Conclusion

There you have it.

Today, we’ve unveiled the true essence of being a claims manager.

Guess what?

It’s not just about processing claims.

It’s about safeguarding the financial health of organizations, one claim at a time.

With our comprehensive claims manager job description template and real-world examples, you’re ready to take the next step.

But why limit yourself?

Explore further with our job description generator. It’s your gateway to meticulously crafted job listings or enhancing your resume to perfection.

Remember:

Every claim managed effectively is a part of the bigger financial picture.

Let’s secure that future. Together.

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