Casualty Manager

Triple-S; Guaynabo (PR); On-site; USD 95,000 - 130,000; Full time

Job summary

Triple-S is seeking a Casualty Claims Manager to lead our casualty claims management efforts, oversee investigations, and supervise adjusters to ensure compliant, timely resolutions. You will collaborate with the Legal Manager to drive litigation strategies and manage reserves and budgets for high-risk claims.

The role requires a Bachelor’s Degree and extensive experience in property & casualty claims, including a Puerto Rico All Lines Insurance Adjuster License.

Qualifications

• Bachelor’s degree from an accredited institution.
• Puerto Rico All Lines Insurance Adjuster License.

Responsibilities

• Supervise and manage legal and non-legal adjusters in the casualty/legal claims area.
• Supervise coverage analysis for all litigated claims and coordinating support for coverage analysis in non-litigated claims.
• Oversee effective investigations of claims, ensuring thorough, accurate and timely reports.
• Manage delegated monetary authority for claims resolution.
• Collaborate with the Legal Manager to develop and implement litigation strategies, including adjustments, expert resources, and budgeting.
• Approve determination of appeal resources, in collaboration with the Legal Manager.
• Oversee approval of billing generated by vendors in claims.
• Manage adequacy of indemnity reserves for casualty/legal claims.
• Administer reporting to reinsurers on claims as required.

Skills

Customer Delight

Data Driven Insights

Develops Talent

Financial & Business Acumen

One Company Mindset

Practical Knowledge in Tech

Education

Bachelor's Degree

Job description

At Triple-S, we are committed to providing meaningful job experiences for Valuable People (Gente Valiosa). We strive for excellence in everything we do, from the way we work together to the way we serve our customers.

When you join Triple-S, you will be key to our efforts on delivering high-quality and affordable healthcare as well as contribute to our purpose to enable healthier lives. We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses.

Job Summary

In charge of leading our casualty claims management efforts, overseeing all aspects of claims handling, from investigation to resolution. Is responsible for managing high-risk claims, ensuring compliance with company policies and procedures, and supervising internal and external personnel. As a key member of our claims leadership team, the Casualty Claims Manager will collaborate with internal stakeholders, including the Legal Manager, to drive tactical plans and make strategic decisions that minimize reputational risk and financial exposure. Provides strategic direction to drive tactical plans of the company, in addition to administrative responsibilities and development of its employees.

Essential Functions

• Supervise and manage legal and non-legal adjusters in the casualty/legal claims area.
• Supervise coverage analysis for all litigated claims and coordinating support for coverage analysis in non-litigated claims.
• Oversee effective investigations of claims, ensuring thorough, accurate and timely reports.
• Manage delegated monetary authority for claims resolution.
• Collaborate with the Legal Manager to develop and implement litigation strategies, including adjustments, expert resources, and budgeting.
• Approve determination of appeal resources, in collaboration with the Legal Manager.
• Oversee approval of billing generated by vendors in claims.
• Manage adequacy of indemnity reserves for casualty/legal claims.
• Administer reporting to reinsurers on claims as required.

EDUCATION

• Bachelor's Degree

Experience

• Bachelor’s degree from an accredited institution with 10 years of experience in Claims adjustment, vast and extensive knowledge of Property and Casualty Policies and Regulations.
• Puerto Rico All Lines Insurance Adjuster License.

COMPETENCIES

• Customer Delight
• Data Driven Insights
• Develops Talent
• Financial & Business Acumen
• One Company Mindset
• Practical Knowledge in Tech

It is company policy to seek for the qualified applicants for positions throughout the company without distinction of race, color, national origin, religion, sex, gender identity, real or perceived sexual orientation, civil status, social condition, political ideologies, age, physical or mental disability, veteran status or any other characteristic protected by law. Drug-free company.

Equality Employment Opportunity/Affirmative Action for People with Disabilities/Veterans. Employer with E-Verify to verify the eligibility of employment of all the new employees.

We encourage Veterans and Disabled to Apply.