Director, Program Claims

AmTrust Financial Services, Inc.; United States; Remote; USD 110,000 - 194,000; Full time

Job summary

An established industry player is seeking a Programs Claims Director to lead a dynamic team in managing complex claims. This role involves overseeing TPA interactions, ensuring compliance with industry standards, and developing staff through specialized training. The ideal candidate will possess strong leadership and analytical skills, along with a thorough understanding of insurance principles. Join a company that values diversity and offers competitive compensation, excellent career advancement opportunities, and a supportive work environment. If you are ready to make an impact in the insurance sector, this is the perfect opportunity for you.

Benefits

Medical & Dental Plans

Life Insurance

Health Care Flexible Spending

Dependent Care

401k Savings Plans

Paid Time Off

Paid Maternity Leave

Paid Paternity Leave

Vision Insurance

Qualifications

• Thorough understanding of laws, principles of coverage, and liability.
• Ability to work with little supervision and direction.
• Effective communication skills in both oral and written form.

Responsibilities

• Oversees escalated claims, ensuring quality and compliance.
• Manages personnel administration and team development.
• Analyzes processes for improvement and efficiency.

Skills

Management Experience

Analytical Skills

Communication Skills

Leadership Skills

Insurance Knowledge

Education

College Degree or Equivalent Experience

Job description

Direct message the job poster from AmTrust Financial Services, Inc.

AmTrust Financial Services, a fast-growing commercial insurance company, has an immediate need for a Programs Claims Director. This position requires previous management experience. This position will manage a team of program claim managers who are overseeing TPA’s handling Amtrust claims. The duties include the technical development of the program claim managers and their TPA oversight files which includes, coverage, liability investigation, development and evaluation of damages, settlement strategy and litigation management. These claims arise in various jurisdictions throughout the country and, as such, experience and adjusters’ license in multiple jurisdictions is required. This position will also have personnel administration responsibilities for the program claim managers under their supervision. Previous experience managing TPA’s is required. Ability to assist in TPA due diligence, implementation and program vetting. Need to be able review coverage forms and offer feedback.

Responsibilities

• Oversees the escalated claims assigned to the unit including reserving, communication with the TPA and internal interested parties, documentation, litigation management, evaluation, negotiation and settlement.
• Ensures all escalated claims eligible or ineligible for payment conform to quality, production standards and specifications.
• Ensures claim processing is consistent with applicable policies, procedures and department guidelines.
• Ensures oversight claims are documented properly in system.
• Reviews issues adjusters are unable to resolve and prepares formal response to consumer complaints.
• Analyzes and approves reserve and settlement authority above Program Claim Manager authority and escalates to Vice President when necessary
• Completes regular quality audits of TPA’s and Program Claim Managers work, records results and counsels staff and TPA’s to bring work to or above standards.
• Prepares regular periodic reports and monitors system reports to ensure adherence to corporate and regulatory standards.
• Completes special projects as assigned.
• Assures that all customers receive quality service.
• Other tasks as assigned by Claims Director.
• Establishes and executes controls to assure that the quality of the work meets or exceeds standards.
• Reviews and analyzes processes, procedures and workflows to identify opportunities for process improvement and efficiency.
• May recruit, hire and recommend or initiate promotions, transfers and disciplinary action.
• Manages personnel administration including employee evaluations and salary administration.
• Participate in the specialized training and handling of complex claim matters and projects requiring advanced claim knowledge and experience.
• Manages the development and training of their team, including monitoring and relaying information to the staff regarding changes in coverage and laws

Qualifications

• Thorough understanding of laws, principles of coverage, liability and insurance industry in general.
• Analytical and human relations skills are critical.
• Leadership skills; ability to plan, organize, delegate and develop staff.
• Effective communication skills; ability to obtain and deliver information to others orally and in written form.
• Ability to carry out detailed written and verbal instructions.
• Ability to work with little supervision and direction.
• Sound command of the English language.
• Ability to operate business technology.
• College degree or 10 years equivalent experience and skills required.
• Valid adjuster’s license in appropriate jurisdictions or ability to obtain such.

#AmTrust

#LI-REMOTE

What We Offer

AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off.

AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities.

AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future.

Seniority level

• Seniority level

  Director

Employment type

• Employment type

  Full-time

Job function

• Job function

  Management

• Industries

  Insurance

Referrals increase your chances of interviewing at AmTrust Financial Services, Inc. by 2x

Inferred from the description for this job

Vision insurance

Medical insurance

401(k)

Paid maternity leave

Paid paternity leave

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