Specialty Claims Manager
Builders Insurance Group · Atlanta, GA, USA
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Position Summary
The Specialty Claims Manager is responsible for overseeing the management, quality, and performance of claims within assigned Specialty insurance programs. The Manager provides claims leadership across the claim lifecycle, from first notice of loss through resolution, while ensuring claims are handled in accordance with policy terms, applicable regulations, carrier requirements, program guidelines, and delegated claims authority.
The Manager serves as a key liaison among the managing general agent MGA, insurance carriers, third-party administrators, claims professionals, defense counsel, brokers, and other stakeholders. The role combines technical claims expertise, operational oversight, vendor management, litigation management, and claims analytics to support high-quality claims outcomes and effective portfolio management.
Responsibilities
- Oversee claims across assigned Specialty insurance programs, from first notice of loss through investigation, evaluation, litigation, settlement, and resolution.
- Establish and maintain claims handling standards, procedures, guidelines, controls, and best practices.
- Review and manage complex, high severity, disputed, and litigated claims, including reserves, settlements, payments, recoveries, and expenses.
- Analyze coverage, policy language, exclusions, endorsements, limits, deductibles, and other provisions; provide guidance on complex coverage issues and disputes.
- Ensure coverage decisions and claims handling are appropriately documented and compliant with policy terms, regulatory requirements, contractual obligations, and delegated authority.
- Oversee litigation strategy, defense counsel, legal expenses, mediations, settlements, and other dispute-resolution activities.
- Escalate significant losses, coverage disputes, bad-faith concerns, and other material issues to senior management and carrier partners.
- Serve as a primary claims liaison with carrier partners, providing timely reporting on significant losses, reserves, litigation, trends, and emerging exposures.
- Prepare claims performance reports and lead regular claims reviews, partner audits, and related follow-up activities.
- Manage relationships with TPAs, adjusters, defense counsel, experts, investigators, and other claims vendors; monitor performance, quality, expenses, and service standards.
- Analyze claims frequency, severity, loss development, reserve adequacy, litigation trends, and other portfolio metrics to identify emerging risks and improvement opportunities.
- Partner with Program Managers, Account Managers, Program Auditors, Actuarial, Finance, Legal, Compliance, Claims and Product teams to apply claims insights to pricing, risk selection, policy wording, portfolio management, and product development.
- Develop claims dashboards, management reports, and performance metrics to support informed decision-making.
- Monitor regulatory and legal developments affecting claims and implement appropriate process or control changes.
- Conduct claims file reviews, quality assurance audits, and compliance reviews; maintain accurate claims records and documentation.
- Identify opportunities to reduce claims leakage, improve operational efficiency, strengthen vendor performance, and enhance claims outcomes.
- Support new program launches, product development, loss-control initiatives, program audits and risk-management strategies from a claims perspective.
- Perform other duties as assigned.
Qualifications
- Bachelor's degree in insurance, risk management, business, finance, or a related field; or an equivalent combination of education and experience
- Five or more years of progressive claims experience, preferably within Specialty, commercial, excess and surplus lines (E&S), MGA, carrier, or program insurance environments
- Experience managing complex commercial or specialty claims
- Knowledge of claims investigation, coverage analysis, reserving, litigation management, and claim resolution
- Experience working with carriers, MGAs, third party administrators (TPAs), brokers, defense counsel, and other claims stakeholders
- Knowledge of insurance policy language and coverage principles
- Ability to analyze claims data and identify trends and emerging exposures
- Skill in communications, negotiations, analytical thinking, and decision-making
- Ability to manage multiple priorities and work effectively in a fast-paced environment
- Experience in one or more specialty lines, such as habitational coverages, commercial property, professional liability, cyber, management liability, errors and omissions (E&O), directors and officers (D&O), or other niche insurance products
- Experience with MGA or delegated-authority insurance programs
- Experience managing TPAs and external claims vendors
- Experience overseeing complex or litigated claims
- Experience with claims audits and carrier reporting
- Knowledge of reinsurance and its impact on claims management
- Professional designation such as Chartered Property Casualty Underwriter (CPCU), associate in risk management (ARM), associate in commercial underwriting (AIC), or similar insurance credential
- Experience with claims management systems, business intelligence tools, and claims analytics
- Proficiency with Microsoft Office and function specific software applications
Let’s talk benefits!
- Competitive Salary
- Bonus Structure
- Profit Sharing
- Medical, Dental, Vision Insurance
- Employer Paid Short Term Disability
- Employer Paid Long Term Disability
- Employer Paid Life Insurance
- Voluntary Life Insurance
- 401K with Company Match
- PTO
About Builders
Builders is a mid-sized mutual with remarkable strengths. Rated A by AM Best, Builders has forged rock-solid financial strength and a reputation for reliability and fairness in fulfilling our promises to customers. Kind, collaborative, and customer-centric, our experienced and passionate teams foster a rewarding atmosphere of excellence, trust, and mutual respect, meriting the “Culture Excellence” honors from Top Workplaces. Flexible and highly personal, our experts leverage deeply supportive partnerships with knowledgeable independent agencies to drive better services and protection for policyholders.
Our financial excellence, amazing people, and powerful partnerships build outstanding outcomes and peace of mind for our agents and their clients. This is what we mean by Insurance Built Strong®.