Claims Manager - Property & Casualty

Tristar Insurance; Philadelphia (Philadelphia County); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical, Dental & Vision insurance

Life & Disability Insurance

401(k) plan

Paid time off

Paid holidays

Referral Bonus

Job summary

Tristar Insurance is seeking a Claims Unit Manager to oversee and direct a claims team in Philadelphia. The role demands high-quality claims handling, compliance with regulations, and excellent client service. The ideal candidate will have extensive experience in claims management and strong leadership abilities.

Education requirements include a Bachelor’s degree in a related field, with a preference for candidates holding five to ten years of relevant experience. Benefits include health insurance and a 401(k) plan.

Qualifications

• High School Diploma or GED required.
• Five to ten years of claims management experience.
• Ability to manage multiple priorities and meet deadlines.

Responsibilities

• Supervise Claims Examiners and Claims Assistants.
• Ensure compliance with company policies and regulations.
• Prepare and evaluate monthly client reports.

Skills

Claims management

Strong analytical skills

Excellent written communication

Leadership skills

Microsoft Office proficiency

Education

Bachelor’s degree in business administration or related field

Job description

Position Summary

Under minimal supervision, manages and directs the activities of a claims unit to ensure high-quality claim handling, client service excellence, and compliance with applicable state laws, regulations, and company policies and procedures.

Duties and Responsibilities

• Directly supervises Claims Examiners and Claims Assistants, including monitoring attendance, performance, coaching, performance evaluations, and disciplinary matters.
• Reviews and addresses scheduled claim activities, including initial reviews, periodic reviews, delays, denials, and other claim-related issues.
• Reviews and approves reserve changes, settlements, awards, and payments within authority limits.
• Conducts file reviews to ensure compliance with company policies, client requirements, and applicable laws and regulations.
• Coordinates, conducts, and documents training sessions related to legislative changes, company procedures, and best practices.
• Conducts and documents internal and external educational sessions.
• Ensures appropriate staffing levels are maintained to support workload demands and service expectations.
• Supervises and approves daily check runs and payment registers.
• Responds to claimant, client, and vendor concerns and resolves issues as appropriate.
• Monitors vendor performance and effectiveness to ensure service quality and compliance.
• Ensures client service instructions and account‑specific requirements are consistently followed.
• Provides operational coverage for examiner vacancies resulting from vacations, leaves of absence, or open positions.
• Prepares, reviews, and evaluates monthly client reports and management information.
• Facilitates internal, external, and client audits.
• Partners with Corporate Operations, Sales, and Client Services teams in support of RFPs, implementations, and client service initiatives.
• Participates in client claim reviews and stewardship meetings.
• Provides account management support for accounts that do not have an assigned Account Manager.
• Monitors branch expenses and approves invoices and related expenditures in accordance with company guidelines.
• Performs other duties as assigned.

Qualifications

Education and Experience

• High School Diploma or GED required.
• Bachelor’s degree in business administration, Risk Management, Insurance, or a related field preferred.
• Five (5) to ten (10) years of progressively responsible claims management or claims handling experience.
• Equivalent combinations of education and experience may be considered.

Knowledge, Skills, and Abilities

• Strong technical knowledge of liability claims handling, statutory regulations, and medical terminology.
• Ability to effectively manage multiple priorities, work within a diary system, and meet strict deadlines.
• Strong analytical, problem‑solving, and decision‑making skills.
• Proficiency in Microsoft Office applications, including Word, Excel, Outlook, and Teams.
• Excellent written and verbal communication skills, including the ability to communicate complex claim matters to clients, claimants, vendors, and staff.
• Demonstrated leadership and employee development skills with the ability to manage individuals with varying levels of experience and expertise.
• Strong interpersonal and relationship‑building skills.
• Excellent customer service and client management skills.
• Ability to maintain confidentiality and exercise sound judgment in sensitive situations.

Benefits

• Medical, Dental & Vision insurance
• Life & Disability Insurance
• 401(k) plan
• Paid time off
• Paid holidays
• Referral Bonus

Mental and Physical Requirements

The role requires moderate mental effort, including reasoning, problem‑solving, and the ability to follow multi‑step instructions, as well as essential mathematical and language skills. Physical demands include light to moderate tasks such as lifting up to 50 lbs, standing, walking, and repetitive finger motions. Working conditions are primarily sedentary, with occasional exposure to environmental factors such as noise and vibrations.