Director of Claims - Get Covered LLC

About Get Covered LLC

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:

  • 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:

  • 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:

  • 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:

  • 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:

  • 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.

• 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.

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