Claims Director (Material/Physical Damage)

Client: Our client is a “A” rated fast growing niche carrier.  Founded in 1956, our client is a leader in providing specialty insurance for the financial industry. They have a history of strong operating and underwriting results, a culture of outstanding employee relations, nimble decision-making, rewarding initiative and results, low turnover and valuing work-life balance

Essential Function:  Responsible for managing this small niche carrier’s entire claims operation. The position oversees the settlement, authorization for payment or denial to insured’s based on coverage, appraisal and verifiable damage.  Ensures complete, accurate and consistent claim settlements.  Initiates and manages legal reviews and investigations when necessary. Plans and directs the company’s claims policies and procedures.  Meets with prospective and new clients as needed.  Responsible for fraud monitoring, compliance, investigation and subrogation.  Oversees third party claims processing.

Primary Responsibilities: 

• Manages claims department employees including hiring, training and development, day-to-day supervision, assignment of clients and work tasks, performance management and discipline, performance appraisal, salary recommendations, and determining department structure and reporting relationships.
• Oversees the settlement, authorization for payment or denial to insured’s based on coverage, appraisal and verifiable damage. 
• Initiates and manages legal reviews and investigations when necessary.
• Coordinates with the company compliance department to ensure that claims policies and procedures are compliant with state regulations.
• Presents to prospective and new clients in conjunction with the sales and marketing department as needed.
• Acts as a customer resource for problems or questions as needed.
• Member of Special Investigation Unit responsible for fraud investigation and compliance.
• Oversees the subrogation process including investigation, correspondence and collection.
• Conducts file reviews of claims handled by managing general agents to ensure the settlement, authorization for payment or denial to insured’s are based on coverage, appraisal and verifiable damage. 
• With the Compliance Department and other staff, conducts audits of TPA Claims Departments to ensure compliance with Ultimate Claim Procedures which include adherence to state claim practice requirement.
• Ensures that procedures are followed and standards met regarding unfair claims practices, licensed vendors, settlement standards and claims volume.
• Reviews and analyzes claims patterns (i.e. frequency, severity) and reports any unusual activity or patterns to members of management.
• Works with technology staff to communicate and implement changes and enhancements to claims systems.
• Authorizes claim payments over Claims Representative authority limits.

Reports to:  President, Lender Services Division

Supervises:  Claims Team (1 Claims Supervisor, 1 Claims Lead, 1 Senior Claims Representative, 7 Claims Representatives)

Education:  Bachelor’s Degree in Business or related field

Experience:  7-10 years of insurance claims experience in positions with increasing responsibility, and possess strong management and supervision experience. Material/Physical Damage experience strongly preferred.

Skills:

• Strong leadership and management skills including employee supervision and development.
• Understands technology and able to communicate system changes and requirements to internal technology staff.
• Strong computer skills including all Microsoft Office products and internal systems.
• Research, investigation and analytical skills.
• Interpersonal, communication and presentation skills.
• Strong knowledge of material/physical damage claims handling, claims concepts, practices, and procedures, and insurance and claims handling best practices.
• Some travel required.