Remote Director of Claims & Compliance

GetCovered, Inc.; United States; Hybrid; USD 115,000 - 145,000; Full time

Job summary

GetCovered, Inc. is seeking a Director of Claims to lead a team handling Master Policy TLL and Contents Claims. You will oversee complex claims, ensure regulatory compliance, and guide the group through disputes and depositions, building a high-performance department.

The role requires 7–10 years in claims with 3–5 years in management, a strong track record in leadership, and excellent communication skills. This is a remote opportunity within the United States.

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.

Responsibilities

• 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.
• 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.
• Maintain a strong understanding of claims regulations, notices, payments, and processing.
• Stay updated on changes in regulations and implement necessary adjustments to procedures.
• Handle complex claim disputes and elevate issues as necessary.
• Manage DOI complaints, ensuring timely and effective resolution.
• Represent the company in depositions and other legal proceedings as required.

Skills

Leadership

Team management

Regulatory compliance

Dispute resolution

DOI complaints

Communication

Education

Bachelor’s degree in Business Administration, Insurance, Risk Management, or a related field

Advanced degree or professional certifications (CPCU, AIC) preferred

Job description

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:
• 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.
• 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. 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.

The pay range for this role is:

115,000 - 145,000 USD per year (Remote (United States))