Director of Claims

About Get Covered LLC

We provide cost-effective coverage with just a few clicks — satisfying residents, property managers, agencies, and distribution partners with a process that is as simple and touchless as possible.

About the role

- As the Director of Claims, you will play a pivotal role in overseeing and directing the claims management process for our Master Policy TLL and Contents Claims. You will be responsible for leading a team of claims adjusters, ensuring compliance with regulations, and handling complex claims and disputes. This position requires a blend of leadership skills, extensive claims adjustment experience, and a deep understanding of claims regulations and processes.

What you'll do

- Leadership and Team Management:

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- Lead, mentor, and manage a team of claims adjusters handling Master Policy TLL and Contents Claims.

- Foster a collaborative and high-performance work environment.

- Provide ongoing training and development opportunities to team members.

- Claims Management:

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- Oversee the adjustment, processing, and resolution of complex claims.

- Ensure all claims are handled in accordance with regulatory requirements and company policies.

- Review and approve claims decisions and settlements.

- Regulatory Compliance:

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- Maintain a strong understanding of claims regulations, including notices, payments, and processing.

- Ensure compliance with state and federal regulations and guidelines.

- Stay updated on changes in regulations and implement necessary adjustments to procedures.

- Dispute Resolution:

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- Handle complex claim disputes and escalate issues as necessary.

- Manage DOI complaints, ensuring timely and effective resolution.

- Represent the company in depositions and other legal proceedings as required.

- Department Development:

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- Develop and implement strategies to improve departmental efficiency and effectiveness.

- Build and maintain strong relationships with external partners and stakeholders.

- Analyze and report on claims trends, performance metrics, and opportunities for improvement.

Qualifications

- Bachelor’s degree in Business Administration, Insurance, Risk Management, or a related field; advanced degree or professional certifications (e.g., CPCU, AIC) preferred.

- Minimum of 7-10 years of experience in claims adjustment, with at least 3-5 years in a managerial role. Experience may be substituted for education requirements.

- Demonstrated experience managing a team of claims adjusters.

- Strong understanding of claims regulations, notices, payments, and processing.

- Proven track record in handling claim disputes, DOI complaints, and legal depositions.

- Excellent leadership, communication, and interpersonal skills.

Originally posted on Himalayas