Job Summary

Leads and directs a team of claims professionals handling Reinsurance and Open Market cyber, media, and technology error and omissions claims and litigation. Manages claims, as well as claims staff, in other areas, including Miscellaneous Professional Liability, Employment Practices Liability, and other specialty liability insurance products. Ensures the claims staff is following company procedures and that benefits are paid to those who are eligible. Analyzes and reviews legal pleadings, documents, and applicable statutes to determine validity of liability claims.

Key Responsibilities

Relying on advanced knowledge and strong leadership skills, this role is accountable for the following responsibilities:
• Supervise and direct a team of claims professionals handling primarily Cyber, Media, and Technology Errors & Omissions claims and manage team workflow.
• Coordinate work activities of the team.
• Responsible for development and coaching of staff to maximize proper handling.
• Build a team-oriented environment by establishing team and individual goals through empowerment.
• Coach and mentor direct reports and provide training opportunities.
• Educate and train team members in the duties and responsibilities of best claims practices.
• Review and evaluate the performance of personnel and define goals.
• Perform quality reviews on claims in compliance with internal and external audit requirements.
• Communicate with internal and external stakeholders, including insureds, brokers/agents, and insurance carrier clients, and provide exceptional customer service.
• Provide in depth coverage analysis and wording interpretation.
• Conduct investigations and evaluate liability to determine validity of complex claims.
• Provide oversight to direct reports with regard to formulation and issuance of coverage position letters, negotiation and resolution of claims, and decision-making within defined authority through delegation and empowerment.
• Prepare and draft complex legal correspondence to affected parties. Maintain electronic claim files. Update files as needed.
• Oversee all aspects of the litigation process for high-exposure liability claims to minimize company risk of loss.
• Negotiate claim settlements within defined authority limit.
• Recommend and present proposed claim resolution and/or settlement terms to management for claims that are in excess of the defined authority limit.
• Develop and maintain processes and procedures for the team in coordination with Claims Department Management.
• Recommend and implement techniques to improve productivity and efficiency and cut costs.
• Oversee outside counsel and vendors related to claims handling responsibilities.
• Keep current on state regulations with issues, industry activities, and trends. • Attend settlement conferences, mediations, and facilitation hearings on the Company's behalf as needed.
• Provide supervision and guidance to less experienced Claims personnel including the review of settlement payments and denials but obtain appropriate authority to issue denials.
• Provide timely and accurate reporting to management and other internal clients including summaries of open/closed claims or other related bordereaux. • Support Claims Department Management and Underwriting unit as needed.
• Obtain and maintain claims adjuster's licenses or other professional designations as required by the Company.
• Oversee the payment of claims on the basis of the coverage of the insurance customer, the proof of damage, and an insurance appraisal.
• Ensure that all claims are valid according to the company policy and consult with legal representation when necessary.
• Review and respond to claim referrals and questions from claims staff.
• Review and respond to claim appeals and grievances.
• Perform claims reviews and makes recommendations based on policy provisions and processing guidelines.
• Prepare and present reports on claims performance, trends, and operational efficiencies to senior management.

Competencies

Planning
• Develop and implement short-term and long-term plans to improve business processes for department.
• Coordinate resources to ensure strategies are executed

Communication
• Communicate team or group plans or results at all organizational levels. • Prepare written and verbal presentations that educate and inform on area of responsibility/expertise.
• Write, or is a major contributor to, management/technical reports or contractual documents

Cost Management
• Lead business process improvement for the department.
• Develop and is accountable for budget of the department.
• Perform cost benefit analyses for the department.

Business Controls and Policies
• Comply with all corporate policies and procedures.
• Identify control objectives for designated function and implement cost effective controls designed to meet those objectives.
• Test controls to determine if they are performing as intended

People Management
• Has full HR responsibility for direct reports including making hiring decisions, training, coordinating work, establishing standards, reviewing work, conducting performance appraisals, and providing coaching or counseling.

The pay range for this position is $146,900-$220,300 which includes geographic adjustments, where applicable. The pay range is the range THMCC, in good faith, believes is the range of compensation for this role at the time of this posting. The hired applicant will be offered pay within the entire range based on the candidate's geographic location, qualifications, work experience, education, and/or skill level.