Leader of Claims, Med-Mal 3rd Party Liability

As the Leader of Claims one must be a dynamic leader, using their organization and investigative skills in a fast-paced environment to guide the claims team and protect VGM Insurance Services insureds. As the leader, one is responsible for guiding their team through all aspects of handling complex Med-Mal third-party liability claims from inception through conclusion brought against our insureds. The responsibilities for this role include making coverage determinations, investigating losses, evaluating and projecting potential exposures, setting judgmental reserves, developing and implementing resolution strategies, managing outside law firms, working with underwriting on policy renewals and promoting client relationships.

Individuals in the role will both lead and guide their team of 3+, and be actively working their own high-complexity claims. Investigate, evaluate, dispose and settle the most complex claims and highest exposures with minimal supervision. Focus areas for this position are: general liability, products/liability, professional liability for DMEPOS. Additional areas of focus include property as our organization continues to explore growth in this area.

The role will work closely with VGM’s in-house legal counsel as well as external counsel brought on to support claims as needed. The Leader will be the expert on claims and the trends affecting the VGM Insurance business, educating peers in Underwriting, Sales, Marketing and Operations.

Reporting Accountability: Senior Vice President of Claims

Working Location: Waterloo, IA with a hybrid/remote work possible days during the week

Hours: Monday- Friday 8-5 Occasional off-hours when job duties require

Responsibilities/Duties of the Position

As the Leader of Claims ones primary duty is to coach and develop a highly skilled and competent claims team to promptly and effectively handle to conclusion all assigned claims. As expected of any VGM employee the leader adheres to high standards of professional conduct while providing delivery of superior claims service. Specific duties may include:

• Provides management and day-to-day direction to the claims team, including: coaching, training and development, performance management and annual reviews. Leads the team of 3+ individuals in Claims
• Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the claim.
• Interacts extensively with various parties involved in the claim process; clearly communicates concise action plans, and presents plans for moving the case to conclusion.
  • Answer and respond to attorney, regulatory, producer and consumer inquiries
• Maintain an effective and organized operation
  1. Processes claims consistent with clients' and corporate policies, procedures and "best practices" and also in accordance with any statutory, regulatory and ethics requirements.
• Ability to work with others and build relationships with claims staff, VGM legal counsel, VGM Underwriting Team, VGM Sales, Marketing and Operations
• Demonstrated ability to comply with carrier reporting and threshold requirements.
• Reviews and analyzes claims data to identify trends.
• Able to recognize and pursue excess insurance recoveries. Handle a full case load, with proven ability to handle cases of increased severity.
• Maintains current knowledge of: multiple insurance lines, court decisions, current guidelines in the claims function, and policy changes and modifications. This may require attendance at various seminars and/or training sessions.

Position Qualifications

Education/Experience:

• Qualified candidates must have leadership experience, 3+ years of formal or informal leadership of others.
• 5+ years in general liability claim review. Individuals must hold an adjuster license; if not currently held or expired, one is required to become licensed and pass all applicable exams within first few months of hire.
• Bachelor's degree preferred or equivalent experience.
• Prior paralegal and/or claims legal experience highly desired.
• Med-Mal experience/exposure desired.

Skills and competencies:

VGM Insurance Services prides itself on customer service and accountability; the Manager of Claims must desire working in a fast-paced environment and have the ability to maintain a high-volume workload managing multiple priorities.

• Knowledge of insurance coverages, contracts, claims handling guidelines, legal and medical terminology.
• Demonstrated ownership attitude and customer centric response to all assigned tasks.
• Strong analytical skills and problem-solving abilities.
• Strong negotiation skills.
• Strong skills in research, coverage evaluations, claim resolution, claims payments and cases.
• Experience handling claims from receipt to resolution including coverage verification, investigation through resolution.
• Strong verbal and written communication skills.
• Attention to detail ensuring accuracy.
• Hard work, honesty, integrity and unwavering business ethics.
• Detail-oriented organizational skills in a multi-tasking environment.
• Success driven individual who has demonstrated success in their career.

Physical Requirements:

• Work in front of a computer for long amounts of time
• Using technology efficiently such as computers, phones, misc. office equipment
• Occasional travel to VGM offices, customers or training when required.

VGM Values

Our values drive how we work and who we hire. You will see these values ingrained in how we support our customers and work with team members in the work environment we’ve created.

• MAKE A DIFFERENCE: Impact our customers by making their lives better or easier. Help our friends and neighbors in need by giving back to the community.
• FIND THE FUN IN YOUR DAY: We can’t have fun without you. Connect with your colleagues, find enjoyment in your work, and don’t forget to laugh.
• PROTECT OUR COMPANY: Embrace the benefits that technology provides but always be proactive in looking for cyber security or other threats.
• PROVIDE MEANINGFUL, MEMORABLE SERVICE: By cherishing our customers and providing excellent service, you make a direct impact in growing VGM and our ESOP.
• WELCOME CHANGE: Stay curious and engage with change. Look at the future by finding areas to improve and be open to new ideas. Inclusion: Support a diverse community where we all belong.
• CHEER EACH OTHER ON: Root for your fellow employee owners. Support them if they’re having trouble and celebrate their successes.
• OWN YOUR OWNERSHIP: Take pride in your employee ownership. Always put your best foot forward and work with purpose.
• CREATE YOUR FUTURE: Your future is in your hands. Every employee has equality of opportunity to learn, grow, and advance.

At VGM, you’ll enjoy:

• Compensation: Highly competitive wage
• Company Ownership: VGM is 100% employee owned meaning employees can earn an annual gift of VGM stock equaling a portion of what you make.
• Fantastic Benefits: 401k and ROTH 401k with up to 3% company match, Health Benefits, HSA options - single to family, Dental, Vision, Short and Long-Term Disability, Term Life and Voluntary Life Insurance and a physician network where you reside
• Casual Dress: VGM has a casual work environment, we call it dress for your day.
• Involvement: Ability to participate in Employee Get Connected Groups, (VGM Young Professionals, Garden Club, Women In Leadership) Volunteering, Company wide celebrations, and more
• Work-life Balance: Paid Holidays with the Holiday of your Choice benefit, Paid maternity and Paternity leave, Foster and Adoption Assistance
• Health and Wellness: Free Walk-in Clinic to all employees & family members regardless of carrying VGM Insurance and 24/7 On-site fitness center and free fitness classes* [All in Waterloo]

At VGM we live by a common set of values that we call our POWER of ONE PRINCIPLES. These are the behaviors that guide how we WORK TOGETHER, how we TREAT ONE ANOTHER and how we SERVE OTHERS. As you consider VGM your future career home we want to highlight that employees will be well compensated as owners of the company [yes, we are 100% employee owned] and have opportunities for growth within VGM – the power to CREATE YOUR FUTURE. In addition to challenging and meaningful work, VGM aspires to MAKE A DIFFERENCE every day in the lives of those we serve and our communities with opportunities to give back and participate in volunteer opportunities. We give our employees the freedom and resources they need, backed by our culture of collaboration and diverse thought, to continue innovating and advancing our services – if you want to be empowered to MAKE A DIFFERENCE, you’ll love it here. 

This job description reflects the general duties of the job but is not a detailed description of all duties which may be inherent to the position. Reasonably related additional duties may be assigned to the individual Associate.

VGM Group, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

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