High degree of specialized and technical competence in claims handling, particularly in file management.
Minimum of 5 years of workers' compensation claims handling experience.
College degree or equivalent business experience required.
Ability to work independently and assimilate diverse learning materials.
Excellent interpersonal, computer, and negotiation skills.
Professional demeanor when dealing with customers.
Responsibilities
Manage a senior examiner caseload with complex coverage and litigation issues.
Conduct high-level investigations in collaboration with the Special Investigations Unit (SIU).
Collaborate with medical resources to address unusual injuries and treatment needs.
Ensure compliance with regulations and manage exposure issues.
Calculate and present significant reserves and settlements to stakeholders.
Implement effective settlement strategies leveraging various financial considerations.
Mentor junior staff and identify their training needs.
Benefits
Opportunity for professional development and mentorship.
Engagement in high-level investigations and complex case management.
Collaboration with medical and compliance teams.
Exposure to a variety of internal and external stakeholders.
Travel opportunities for in-person claim reviews.
Full Job Description
Job Description
Claim Director will handle a senior examiner caseload that includes severity exposures with complex coverage, compensability, litigation, or account management issues.
Claim Director will be expected to
Have advanced diary management, file documentation, action planning, reserve and exposure analysis skills Demonstrate ability to use internal and external resources to make appropriate, timely decisions independently and within authority
Conduct or work with SIU to direct high level investigations
Collaborate with medical resources to manage unusual injuries and treatment needs
Address compliance issues and exposures
Calculate and present significant reserves and settlements to internal & external customers
Use effective settlement strategies that leverage MSA, structure and subro issues
Use technical expertise and business acumen to handle account management issues
Develop capacity to work with the WC management team on projects like new hire on-boarding, compliance training and workflows, best practice audit follow-up
Mentor junior staff and help identify their training needs
Exceptional organizational, prioritization and time management skills
Open communication style that fosters continuous learning and team collaboration
Advanced team work, collaboration and account management skills
Outstanding written, oral and presentation skills that are effective with a wide variety of internal and external customers.
Strong business acumen and understanding of the fundamental components of claims, underwriting, agency relationships, industry strategies and trends.
High level of accuracy with claim financials: benefits issuance, bill payment, coding, reserves and inventory management and ability to articulate the impact of claims transactions on internal and external customer's interests.
Exceptional negotiation skills and resources with demonstrated ability to coach others in use of these techniques.
Extensive knowledge of insurance contracts, investigation techniques, legal requirements, state compliance and insurance regulations.
Travel: Yes, 10% of the time for an occasional in person claim review.
Qualifications
Should have high degree of specialized and technical competence in the handling of claims with emphasis on hands-on file management.
Minimum of 5 years of work comp claims handling experience.
College degree or equivalent business experience.
Ability to work independently and assimilate learning materials on many different subjects from various sources.
Excellent interpersonal communications, computer and negotiation skills.
Ability to deal with customers in a professional manner.
About Chubb
Chubb Limited is a Swiss-based global insurance company that provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance (A&H), reinsurance, and life insurance to a diverse group of clients. Chubb operates in 54 countries and territories and is the world's largest publicly traded property and casualty insurance company. The company has a long history, dating back to 1882, and has grown through a series of mergers and acquisitions. Chubb is known for its high-quality insurance products and services, as well as its strong financial performance and commitment to corporate social responsibility.
