Manages claims and litigation activities, including coverage analysis, reserves, liability evaluation, settlements, defense counsel oversight, audits, policies, workflow, reporting, and staff performance. The role supervises claims professionals handling medical malpractice and severe bodily injury claims, ensures regulatory and company compliance, supports training and strategic planning, and advises leadership on claim status and settlement decisions.
The Manager, Claims is responsible for all claims and litigation management activities for the claims professional staff. They will monitor the file handling and reserve setting by assigned staff as well as oversee and evaluate the work of defense counsel utilized by assigned staff for timely and cost effective case disposition.
Essential Duties & Responsibilities
- Analyze and verify insurance coverage for claims brought against policyholders.
- Assure timeliness and adequacy of reserves on claim files, approve or recommend adjustments as necessary.
- Assign losses to claim staff for disposition of claims.
- Evaluate liability, damages and causation and approves settlements (if appropriate) up to approved limit of authority.
- Advise Claims leadership on claims status and attend Reserve & Settlement Committee Meetings as necessary. Ensure timely reporting to the Reserve and Settlement Committee.
- Determine work procedures, manage work schedules, and expedite work flow.
- Maintain existing and develop new claims policies and procedures to improve the overall function of the department.
- Interact with other departments as necessary to help facilitate and coordinate services to our insured and clients.
- Conduct quarterly audits of consultant case files and ensure that file management guide protocols are current and reflective of proper claim handling practices
- Monitor staff to identify and implement training needs and ensure compliance with the Company claims handling requirements.
- Track and monitor results, recommend improvements and participate in departmental strategic planning.
- Manage assigned staff to include performance evaluations, time off, time card review, recognition and disciplinary issues.
- May monitor trials as necessary.
- As directed, assist Claims leadership in the development of claims related marketing strategies and tools for client retention and new business cultivation.
Education, Requirements & Competencies
- Bachelor's degree (B. A.) from four-year college or university
- 8 years’ experience in handling medical malpractice claims or heavy bodily injury claims preferred
- A minimum of 3 years of supervisory/management experience.
- Must have broad knowledge of medicine and familiarity with legal concepts and trends in litigation. Must be knowledgeable in insurance policy contracts, particularly medical malpractice and general liability.
- Formal nursing and/or legal education is also a plus, but not required.
The base salary range for this role is $132,300 - $178,900. Individual compensation packages are based on a variety of factors that are unique to each candidate including geographic location, skill set, experience, qualifications and education.
If you're a caring and customer focused individual who enjoys working with passionate team members, Coverys is the right company for you!
Coverys Inc. Boston, Massachusetts, USA Office
One Financial Center, 13th Floor, 675 Atlantic Avenue, Boston, MA, United States, 02111
Similar Jobs
Artificial Intelligence • Fintech • Insurance • Marketing Tech • Software • Analytics
Leads a multi-state casualty claims organization of more than 300 professionals across Auto and General Liability lines. Accountable for claims outcomes, loss costs, expenses, customer experience, operational readiness, emerging risks, and talent development. Establishes regional priorities, manages resources, develops leadership pipelines, supports continuous improvement, and partners with underwriting, customers, agents, and brokers. The position requires advanced insurance and claims expertise, strong analytical and leadership capabilities, and experience managing large, complex operations.
Information Technology
Manages claims-domain testing for Medicaid and Medicare MMIS healthcare projects. Defines test strategies, plans, scenarios, traceability matrices, and reports; validates end-to-end claims flows, interfaces, EDI files, business rules, configurations, and backend data. Collaborates with developers, architects, clients, and business stakeholders, conducts milestone demos, resolves issues, performs root-cause analysis, and supports implementation decisions across claims intake, adjudication, payment, and reporting.
Top Skills:
Azure DevopsCmdsEdi X12FacetsGhsJIRAMmisPostmanSQL
Fashion • Social Impact • Agriculture
Manages claims and labeling policies, procedures, guidance, tools, and stakeholder support across Textile Exchange standards. Leads policy revisions, consultations, ISEAL compliance, trademark and claims inquiries, legislative risk collaboration, training, and project delivery. Supervises staff through goal setting, coaching, performance management, and professional development. Works globally with certification bodies, brands, manufacturers, and other stakeholders to ensure credible, consistent claims and labeling practices.
Top Skills:
Power BISalesforce
What you need to know about the Boston Tech Scene
Boston is a powerhouse for technology innovation thanks to world-class research universities like MIT and Harvard and a robust pipeline of venture capital investment. Host to the first telephone call and one of the first general-purpose computers ever put into use, Boston is now a hub for biotechnology, robotics and artificial intelligence — though it’s also home to several B2B software giants. So it’s no surprise that the city consistently ranks among the greatest startup ecosystems in the world.
Key Facts About Boston Tech
- Number of Tech Workers: 269,000; 9.4% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Thermo Fisher Scientific, Toast, Klaviyo, HubSpot, DraftKings
- Key Industries: Artificial intelligence, biotechnology, robotics, software, aerospace
- Funding Landscape: $15.7 billion in venture capital funding in 2024 (Pitchbook)
- Notable Investors: Summit Partners, Volition Capital, Bain Capital Ventures, MassVentures, Highland Capital Partners
- Research Centers and Universities: MIT, Harvard University, Boston College, Tufts University, Boston University, Northeastern University, Smithsonian Astrophysical Observatory, National Bureau of Economic Research, Broad Institute, Lowell Center for Space Science & Technology, National Emerging Infectious Diseases Laboratories
