Client Claims Director

Crawford & Company in; Peachtree Corners (GA); On-site; USD 120,000 - 180,000; Full time

Benefits offered by this job

Excellent Crawford Benefits

Employee Referral Bonus Program

Employee Discounts

Job summary

Crawford & Company seeks a Client Claims Director (Finance) to lead designated client claims programs, drive process improvements, and oversee investigations, reserves, and audits. You will coach staff, manage client reporting, and collaborate with senior management to meet service expectations.

You will partner with executives and managers to optimize staffing, quality, and outcomes, ensuring adherence to client instructions and industry best practices.

Qualifications

• College Degree preferred or education equivalent to a college degree or the equivalent experience in related work experience.
• Attainment of the Associate in Claims designation, and successful completion of, or active study for, I.I.A. MGT 43, and MGT 44, or the equivalent in related studies or work experience.
• Demonstrated ability to supervise the work of others.

Responsibilities

• Serve as the primary claims liaison for a designated client, driving program enhancements, client-specific directives, and claims process improvements.
• Partner with Adjusters, Team Leaders, Team Managers, and Service Center Managers to enhance claim quality, staffing strategies, operational efficiency, and claim outcomes.
• Monitor claim performance through analytics, ensuring compliance with client Special Handling Instructions, Best Practices, and service expectations.
• Oversee claim operations, including investigations, reserve management, workflow optimization, litigation management, and claim file audits.
• Coach and educate claim staff on customer service, technical claim handling, supervision standards, reserve controls, data accuracy, and quality results.
• Manage client reporting and statistical data while ensuring effective utilization of Medical Management Services, Subrogation Vendors, SIU Services, Attorneys, and other program resources.
• Assists in the section, training and development of an effective and efficient staff.
• Monitors key metrics on a daily, weekly or monthly level as needed.
• Undertake reviews, based on predetermined criteria or as applicable, to ensure proper investigation and data collection.

Education

College Degree preferred or education equivalent

Associate in Claims designation

MGT 43 / MGT 44 or equivalent

Job description

Client Claims Director (Finance)

We're Hiring: Client Claims Director

Business Segment: Broadspire

This is an exciting opportunity to join a global leader in claims management and make a meaningful impact through your expertise.

Why Join Crawford & Company?

Excellent Crawford Benefits that Empower Financial, Physical, and Mental Wellness

Generous Employee Referral Bonus Program

Access to Multiple Employee Discounts

Role Overview

• Serve as the primary claims liaison for a designated client, driving program enhancements, client-specific directives, and claims process improvements.
• Partner with Adjusters, Team Leaders, Team Managers, and Service Center Managers to enhance claim quality, staffing strategies, operational efficiency, and claim outcomes.
• Monitor claim performance through analytics, ensuring compliance with client Special Handling Instructions, Best Practices, and service expectations.
• Oversee claim operations, including investigations, reserve management, workflow optimization, litigation management, and claim file audits.
• Coach and educate claim staff on customer service, technical claim handling, supervision standards, reserve controls, data accuracy, and quality results.
• Manage client reporting and statistical data while ensuring effective utilization of Medical Management Services, Subrogation Vendors, SIU Services, Attorneys, and other program resources.

• College Degree preferred or education equivalent to a college degree or the equivalent experience in related work experience.
• Seven more years of progressive technical claim experience, including supervisory and/or management experience, demonstrating a high degree of judgment and discretion, is capable of providing adequate guidance and support on administrative and technical claim matters.
• Attainment of the Associate in Claims designation, and successful completion of, or active study for, I.I.A. MGT 43, and MGT 44, or the equivalent in related studies or work experience.
• Demonstrated ability to supervise the work of others.
• Demonstrates effective and diplomatic oral and written communication skills, and promotes a favorable company image to the public.
• None

• Assists in the section, training and development of an effective and efficient staff.
• Monitors key metrics on a daily, weekly or monthly level as needed. Key metrics include general metrics as well as those specifically targeting client initiatives.
• Along with Account Executive, communicates Client's expectations and ensures compliance via interaction with Team Manager and Service Manager.
• Provides claim specific guidance to staff as applicable ensure proper investigation and timely equitable disposition of claims. Makes recommendations on reserves exceeding pre-determined authority level; conducts periodic reserve reviews to identify areas of concern and work with Team Manager to resolve.
• Analyzes files on a periodic basis to determine accuracy and completeness and to maintain control of quality of work.
• Works with Team Manager and Service Center Manager to ensure that claim personnel are knowledgeable on client special handling instructions, carrier requirements and work reflects same.
• Keeps VP of Claim Operations informed verbally and in writing of activities and problems within assigned area of responsibility; refers matters beyond limits of authority and expertise to SVP and VP of Claim Operations.
• Participates in special projects or performs duties in other areas as requested.
• Undertake reviews, based on predetermined criteria or as applicable, to ensure proper investigation and data collection.
• Works with staff to ensure training has taken place in the proper evaluation of claims from a legal, medical, and financial standpoint.
• Handle client concerns quickly and efficiently to resolution