AmTrust Financial Services

Director, Program Claims

AmTrust Financial Services$100K — $130K *
US-AnywhereRemote in United States
Finance & Insurance
8 - 10 years of experience
Job Overview by Ladders

Qualifications

  • 5-7 years of management experience in claims oversight required.
  • Valid adjuster's license in multiple jurisdictions is necessary.
  • Strong understanding of liability, coverage principles and the insurance industry.
  • Proven leadership abilities in training and developing teams.
  • Critical analytical and human relations skills required.
  • Excellent communication skills, both oral and written.
  • College degree or equivalent experience (10 years) needed.

Responsibilities

  • Oversees and manages escalated claims, ensuring quality communication with TPA.
  • Ensures claims comply with quality and production standards.
  • Maintains adherence to policies and guidelines in claims processing.
  • Documents oversight claims accurately in the management system.
  • Analyzes and approves reserves and settlements exceeding authority limits.
  • Conducts quality audits and coaches Program Claim Managers on performance.
  • Participates in special projects and prepares regular reports to monitor compliance.

Benefits

  • Comprehensive Medical & Dental Plans.
  • Life Insurance coverage for employees and families.
  • Flexible Spending Accounts for healthcare and dependent care.
  • 401k Savings Plans for retirement.
  • Generous Paid Time Off policy.
Full Job Description
Overview

This position requires previous management experience. This position will manage a team of program claim managers who are overseeing TPA’s handling Amtrust claims. The duties include the technical development of the program claim managers and their TPA oversight files which includes, coverage, liability investigation, development and evaluation of damages, settlement strategy and litigation management. These claims arise in various jurisdictions throughout the country and, as such, experience and adjusters’ license in multiple jurisdictions is required. This position will also have personnel administration responsibilities for the program claim managers under their supervision. Previous experience managing TPA’s is required. Ability to assist in TPA due diligence, implementation and program vetting. Need to be able review coverage forms and offer feedback.

Responsibilities
  • Oversees the escalated claims assigned to the unit including reserving, communication with the TPA and internal interested parties, documentation, litigation management, evaluation, negotiation and settlement.
  • Ensures all escalated claims eligible or ineligible for payment conform to quality, production standards and specifications.
  • Ensures claim processing is consistent with applicable policies, procedures and department guidelines.
  • Ensures oversight claims are documented properly in system.
  • Reviews issues adjusters are unable to resolve and prepares formal response to consumer complaints.
  • Analyzes and approves reserve and settlement authority above Program Claim Manager authority and escalates to Vice President when necessary
  • Completes regular quality audits of TPA’s and Program Claim Managers work, records results and counsels staff and TPA’s to bring work to or above standards.
  • Prepares regular periodic reports and monitors system reports to ensure adherence to corporate and regulatory standards.
  • Completes special projects as assigned.
  • Assures that all customers receive quality service.
  • Other tasks as assigned.
  • Establishes and executes controls to assure that the quality of the work meets or exceeds standards.
  • Reviews and analyzes processes, procedures and workflows to identify opportunities for process improvement and efficiency.
  • May recruit, hire and recommend or initiate promotions, transfers and disciplinary action.
  • Manages personnel administration including employee evaluations and salary administration.
  • Participate in the specialized training and handling of complex claim matters and projects requiring advanced claim knowledge and experience.
  • Manages the development and training of their team, including monitoring and relaying information to the staff regarding changes in coverage and laws
  • Escalates TPA service issues
Qualifications
  • Thorough understanding of laws, principles of coverage, liability and insurance industry in general.
  • Analytical and human relations skills are critical.
  • Leadership skills; ability to plan, organize, delegate and develop staff.
  • Effective communication skills; ability to obtain and deliver information to others orally and in written form.
  • Ability to carry out detailed written and verbal instructions.
  • Ability to work with little supervision and direction.
  • Sound command of the English language.
  • Ability to operate business technology.
  • College degree or 10 years equivalent experience and skills required.
  • Valid adjuster’s license in appropriate jurisdictions or ability to obtain such.

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What We Offer

AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off.

 

About AmTrust Financial Services

AmTrust Financial Services, Inc. is a multinational property and casualty insurance company. The company provides coverage for small businesses, workers' compensation insurance, extended warranty coverage, specialty risk and extended warranty coverage, and other insurance products. AmTrust Financial Services, Inc. was founded in 1998 and is headquartered in New York City. The company is publicly traded on the NASDAQ stock exchange under the ticker symbol AFSI.
Learn more about AmTrust Financial Services
Size
8,000 employees
Industry
Founded
1998

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