Job Title: Director of Claims
Reports to: Chief Executive Officer
General Summary:
The Director of Claims is responsible for establishing proper procedures and policies to be utilized throughout the lifecycle of the claims resolution process. This position endeavors to ensure company goals are met in conjunction with compliance of legal requirements as they relate to the Claims department. This position is responsible for ensuring loss payments, expenses, recoveries, and other similar Claims financial transactions are properly allocated and recorded within department systems. Position is responsible for goal achievement, support, and overall production of the Claims Department.
Key Roles and Responsibilities:
- Set policy and procedure to ensure timely and fair claims settlements in accordance with the Unfair Claim Settlement Practices Act and with policy provisions.
- Establishes proper claims reserve and payment policies for losses. Manages and monitors for timeliness, adequacy and accuracy.
- Manages Claims Department workloads and maintains proper staffing with the assistance of Senior Claims staff.
- Tracks and administers Fleet company vehicle assignments to Claims staff.
- Prepares and monitors budget for Claims Department.
- Evaluate and execute action on complex legal matters as it relates to the Claims Department. Participates in large exposure mediations and settlement conferences.
- May be required to act as witness in litigation filed against the company.
- Reviews and authorizes law firms and billing rates for Claims staff usage approval.
- Maintains open communication channel with other departments and Management, including but not limited to: Underwriting, Finance, Human Resources and IT.
- Reviews management reports and implements corrective actions identified.
- Develops and produces management reports based on current business needs.
- Establish departmental business direction, identifying employee/team objectives and managing associated plans.
- Understand employees' skill, determine strengths and weaknesses, and identify potential leadership.
- Provide direction and leadership to employees on the claims team. Provide technical claims management expertise to all employees.
- Administer employee evaluations to assess development and attainment of goals.
- Administer Human Resource policies and procedures as it relates to Claims.
- Responsible for Claims employee discipline/termination handling and administration.
- Prepare for and participate in audits by reinsurers, internal staff, and regulators.
- Maintain methods for catastrophe and individual risk reinsurance reporting and tracking. Foster relationships with reinsurers.
- Maintain record of all Claims vendor contracts & renewal dates. Evaluate need and necessity of services provided on a regular basis.
- Negotiate vendor services and applicable fees. Review, modify, and approve contracts.
- Coordinate and assist vendors in implementation of new systems and services.
- Maintain a log and monitor the resolution of complaints filed through the DOI (Department of Insurance).
- Direct execution of file reviews and/or surveys. Review results, and act as necessary.
- Provide Qualitative and Quantitative information to Management as required.
- Maintain a presence in the overall Claims industry. Recognize and evaluate current trends and business processes.
- Regularly analyzes workflow process of entire department in consideration of emerging technology, identifying opportunities to operate Claims organization more efficiently.
- Completes a monthly Claims presentation and delivers to the Board of Directors and CEO.
- Addresses & resolves elevated customer complaints regarding Claims related issues.
- Act as a liaison between the Claims department and agencies. Discuss and review agents elevated complaints regarding their customer's claims. Also assist with other agent related functions on an as needed basis (i.e., convention)
- Assist agents and underwriters in determining the proper type of policy/endorsements for a customer with unique risks.
- Develops training material and delivers presentations for high level insurance classes offered by the company to new employees and agents.
- Keeps the CEO informed as to developments that substantially affect our business.
- Other duties as assigned.
Skills/Qualifications:
- Bachelor's degree required (Graduate degree preferred)
- CPCU &/or AIC designation preferred
- Ten years experience in a technical P&C Claims role
- Strong Leadership & Interpersonal skills
- Strong analytical, technical, negotiation, and decision-making skills
- Excellent oral and written communication skills
- Basic understanding of technology and related business processes
Work Environment:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this Job, the employee is regularly required to sit for prolonged periods of time; use hands and fingers to handle or feel; reach with hands and arms, talk and hear. The employee is frequently required to walk. The employee is occasionally required to stand; climb or balance and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus. The noise level in the work environment is usually moderate.
AFR is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, gender, religion, sex, sexual orientation, age, disability, military status, or national origin or any other characteristic protected under federal, state, or applicable local law.
*Please note that employment at AFR is contingent upon a clear drug and background check.