Description

Manager, Claims Operations

Hybrid work Schedule

Buffalo, NY

Merchants Insurance Group, a Northeast leader in Property and Casualty Insurance, has an exciting and rewarding career opportunity for a Manager, Claims Operations to join our collaborative and dynamic Claims team in our Corporate Headquarters located in Buffalo, NY.

The Manager, Claims Operations is responsible for leading and mentoring a team of talented claim leaders and professionals across multiple functional areas within the claims department, including Subrogation, Special Investigation Unit (SIU), Quality Compliance, claims data analytics, and claims projects. This role ensures operational excellence, adherence to regulatory standards, and the achievement of departmental goals through strategic leadership, process optimization, and data-driven decision making. The Manager, Claims Operations is also responsible for the continued training and development of the team through informal knowledge transfer and formal training activities

Merchants Insurance Group, rated A- (Excellent) with a stable outlook by the A.M. Best Company, is proud to be one of Buffalo Business First's Best Places to Work in Western New York (2023-2025), a Fast Track company (2019-2024), and a Top Private Company (2019-2024). Merchants has been granted Ward's 50 designation as a top-performing property-casualty insurance company for four consecutive years. In October 2024, Newsweek and Statista included Merchants Insurance Group on their first-ever America's Most Reliable Companies list, which highlights organizations that other companies can feel confident doing business with in 2025. Of 1,500 B2B companies evaluated, Merchants was one of only 300 companies to make the list.

Merchants offers its colleagues a Hybrid work schedule. The Hybrid work schedule requires 8 full days per month in the office, with the option to work the remaining days at home or in the office. This exciting Hybrid Work benefit offers colleagues a flexible work schedule with the ability to remain connected with their Merchants team and colleagues.

Essential Duties and Responsibilities include, but are not limited to:

Responsible for managing claim units responsible for several claim technical disciplines, including but may not be limited to Subrogation, SIU, Quality Control & Compliance and analytics teams.

Ensures minimization of claim impact on combined ratios and other company level financial metrics. Analyzes results, including all claim key performance indicators and takes corrective action as necessary to improve results.

Collaborate with department managers to develop and implement strategies for optimizing recovery efforts, identifying fraudulent activity, ensuring quality, and maintaining compliance. Evaluate departmental workflows and processes, ensuring efficiency and consistency across operations, including data analytics, and claims projects.

Work with Subrogation leadership to develop and implement strategies for maximizing recoveries and reducing cycle times. Monitor workflows and ensure timely pursuit of claims against responsible third parties.

Collaborates with Quality Control & Compliance leadership to maintain rigorous auditing and quality assurance standards. Ensure claims-handling practices meet legal and regulatory requirements.

Partner with the SIU manager to ensure thorough investigation of potential fraudulent claims. Oversee strategies to mitigate fraud risks while ensuring compliance with industry standards and regulations.

Oversee the development and use of data analytics to identify trends, measure performance, and support strategic decision making. Monitor key performance indicators (KPIs) for all functional areas under managers purview.

Conducts claim file reviews as necessary to ensure internal and regulatory compliance and as a diagnostic tool to improve business results.

Qualifications & Skills:

Qualified candidates will have a 4 year degree or equivalent work related experience.

5+ years claims management experience, with expertise in subrogation, fraud investigation, quality assurance and compliance and claims data analytics.

High level of claims technical knowledge.

Proficient with state and federal laws affecting claims handling.

Proven leadership experience, including managing cross-functional teams.

Knowledge of local industry developments and trends.

Microsoft Office knowledge as well as the ability to work with internal company systems (WINS, ImageRight etc.).

Exceptional organization, verbal and written communication skills are highly desirable.

Merchants Insurance Group Pay information:

Merchants Insurance Group offers a competitive pay scale. Merchants Insurance Group offers a competitive pay scale. The estimated salary for this role ranges from $110,000 - $145,000 based on leveling and geography, along with an equity component and a comprehensive benefits package. This range is merely an estimate; actual compensation may deviate from this range based on skills, experience and qualifications.

Merchants Insurance Group Benefits:

Welcoming and positive work environment.

Flexible work arrangements, including flex scheduling and summer hours.

Hybrid work schedule. The Hybrid work schedule will require 8 full days per month in the office, with the option to work the remaining days per month at home or in the office.

Colleague Appreciation Events.

Competitive pay scale.

Outstanding company bonus program.

Generous paid time off package.

Full Benefits: Health, Dental, Vision, Life Insurance, Short Term Disability, 401(k) employer match amount is 100% up to 6% of your annual contributions. You are immediately 100% vested in the employer match dollars.

Tuition Reimbursement.

And many more exciting company benefits!! EOE

Qualifications

Experience

Preferred

5-10 years: 5+ years claims management experience, with expertise in subrogation, fraud investigation, quality assurance and compliance and claims data analytics.

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

Merchants Insurance Group

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