The Important Role of a Claims Manager

There are many different jobs and professions which one can engage in these days. From participating in the medical field to being a sales representative for a small company, one who is searching for a job has a wealth of options available to them.

One such position which interests many job seekers is that of a claims manager. By looking at the general responsibilities of a claims manager and the specific duties which they undertake each and every day in their job position, one can make an informed decision whether the job position of claims manager is right for them.

What Is a Claims Manager?

Prior to detailing the responsibilities and duties of a claims manager, it is important to define the position of a claims manager. A claims manager is an individual who works with insurance claims to ensure that insurance issues have been settled and claims have been paid out to interested parties. They must also ensure that the payments which were made were correct and in accordance with company regulations.

General Responsibilities of a Claims Manager

A claims manager is responsible for undertaking many jobs related to their position. As for general responsibilities, one who is a claims manager must maintain the insurance claim files, review such files and ensure that payments have been completed and are correct. They must follow up with any and all issues related to the insurance claims and direct such issues to pertinent parties when necessary to have them resolved by those individuals. In the case of litigation regarding the insurance claims, it is the claims manager’s responsibility to discuss the matter with legal counsel and aid them in pursuing the litigation.

Specific Duties of a Claims Manager

One who fills the role of claims manager will find that their days are chock full of duties relating to the carrying out of their occupation. One specific duty of a claims manager is to maintain insurance claim files. They must keep the files in an organized manner and store them in a secure location where they will not get lost or misplaced. They need to ensure that the insurance claim files are able to be pulled out whenever they are needed for review or action.

An individual who is a claims manager is also responsible for reviewing voluminous documents relating to insurance claims. They must review insurance claim files to check on the status of the file and ensure that claims have been paid out in a proper manner. The claims manager is the individual who checks to see that claims have been filed in accordance with the rules and regulations of the insurance company.

The claims manager must also complete a large amount of correspondence in their daily job duties. The correspondence may take place via a variety of methods such as telephone, postal mail, email, fax and in person. Correspondence will be between the claims manager and claimants, company officials, doctors and lawyers. This type of communication is engaged in for a variety of reasons such as ensuring that payment is/was made, resolve issues and obtain necessary information so that the claims payments can be made as quickly as possible.

A claims manager must also undertake the completion of a number of different reports. These reports must be made for a variety of reasons at various times such as during the claims payment process or at the completion of a claims matter. The reports will usually details current issues with a claims payment or state the resolution of a claims matter.

Claims managers must also deal with reserve issues. The reserve issues will be reviewed to ensure that they are in accordance with company procedures. Written and verbal reports on these issues will be given by the claims manager on a periodic basis.

One who is a claims manager must also provide verbal updates and lectures to company officials and other employees regarding general or specific claims issues. The amount of updates or lectures one is required to give will depend on a variety of factors such as their position in the company and amount of claims issues which need to be discussed.

Positive Traits for all Claims Managers to Possess

Although every claims manager is different, there are a few different traits which claims managers can really use in their daily work environment. An important positive trait for claims managers to possess is wonderful analytical skills. Claims managers spend much of the day reviewing insurance claim files and documents to ensure that claims have been paid and they have been paid correctly. If a claims manager has good analytical skills, they will be that much more likely to breeze through their daily job routine in an easy and efficient manner.

One who is a claims manager should also deal well with other individuals. Since claims managers will often have to consult with other company employees and outside parties, it is important that they know how to deal with others in an effective and efficient manner. By doing so, the claims manager will help to complete their job duties the best way possible.

Good public speaking skills are also important for a claims manager to possess. Claims managers have to give verbal reports and lectures on a frequent basis so it is helpful if the claims manager possesses good public speaking skill as this will help them in this part of the job.

Wonderful researching skills will also aid the claims manager in their daily job duties regarding the insurance field. Many times the claims manager will have to search for the answer which they are looking for, whether it be relating to a particular case file or pertain to company rules and regulations regarding claims. Whatever the case may be, excellent researching skills will help the claims manager carry out their duties.

Conclusion

Filling the position of claims manager will provide an individual with interesting work on a daily basis. As every insurance claim is different, the claims manager will appreciate the fact that their job will vary from day to day as they will have to deal with a variety of insurance claim issues. If one is looking for a position which allows the employee to apply wonderful analytical and researching skills as well as correspond with a variety of different individuals, becoming a claims manager might just be the perfect position for that individual to apply for at an insurance company.