Director of Claims

GetCovered

$115K — $145K *
US-AnywhereRemote in United States
Finance & Insurance
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in Business Administration, Insurance, Risk Management, or related field; advanced degree or professional certifications (e.g., CPCU, AIC) preferred.
  • Minimum of 7-10 years in claims adjustment; 3-5 years in a managerial role.
  • Experience managing a team of claims adjusters.
  • Strong understanding of claims regulations, notices, payments, and processing.
  • Proven track record in handling claim disputes, DOI complaints, and legal depositions.
  • Excellent leadership, communication, and interpersonal skills.

Responsibilities

  • Lead, mentor, and manage a team of claims adjusters handling Master Policy TLL and Contents Claims.
  • Foster a collaborative and high-performance work environment.
  • Provide ongoing training and development opportunities to team members.
  • Oversee the adjustment, processing, and resolution of complex claims.
  • Ensure compliance with regulatory requirements and company policies for all claims.
  • Review and approve claims decisions and settlements.
  • Handle complex claim disputes and escalate issues as necessary.

Benefits

  • Remote work flexibility within the United States.
  • Opportunities for professional development and training.
  • Participation in a collaborative, high-performance culture.
  • Engagement with external partners and stakeholders.
  • Involvement in developing departmental efficiency and effectiveness strategies.
Full Job Description
About the role

  • As the Director of Claims, you will play a pivotal role in overseeing and directing the claims management process for our Master Policy TLL and Contents Claims. You will be responsible for leading a team of claims adjusters, ensuring compliance with regulations, and handling complex claims and disputes. This position requires a blend of leadership skills, extensive claims adjustment experience, and a deep understanding of claims regulations and processes.

What you'll do

  • Leadership and Team Management:
    • Lead, mentor, and manage a team of claims adjusters handling Master Policy TLL and Contents Claims.
    • Foster a collaborative and high-performance work environment.
    • Provide ongoing training and development opportunities to team members.
  • Claims Management:
    • Oversee the adjustment, processing, and resolution of complex claims.
    • Ensure all claims are handled in accordance with regulatory requirements and company policies.
    • Review and approve claims decisions and settlements.
  • Regulatory Compliance:
    • Maintain a strong understanding of claims regulations, including notices, payments, and processing.
    • Ensure compliance with state and federal regulations and guidelines.
    • Stay updated on changes in regulations and implement necessary adjustments to procedures.
  • Dispute Resolution:
    • Handle complex claim disputes and escalate issues as necessary.
    • Manage DOI complaints, ensuring timely and effective resolution.
    • Represent the company in depositions and other legal proceedings as required.
  • Department Development:
    • Develop and implement strategies to improve departmental efficiency and effectiveness.
    • Build and maintain strong relationships with external partners and stakeholders.
    • Analyze and report on claims trends, performance metrics, and opportunities for improvement.

Qualifications

  • Bachelor's degree in Business Administration, Insurance, Risk Management, or a related field; advanced degree or professional certifications (e.g., CPCU, AIC) preferred.
  • Minimum of 7-10 years of experience in claims adjustment, with at least 3-5 years in a managerial role. Experience may be substituted for education requirements.
  • Demonstrated experience managing a team of claims adjusters.
  • Strong understanding of claims regulations, notices, payments, and processing.
  • Proven track record in handling claim disputes, DOI complaints, and legal depositions.
  • Excellent leadership, communication, and interpersonal skills.


The pay range for this role is:

115,000 - 145,000 USD per year (Remote (United States))

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