Claims Director

Chubb•Alpharetta, GA

About The Position

The Claims Director handles a senior examiner caseload that includes severity exposures involving complex coverage, compensability, litigation, or account management issues. The role requires advanced technical claims expertise and hands-on file management, with responsibility for making timely decisions independently and within authority, managing significant claim exposures, and presenting reserves and settlements to internal and external customers. The Claims Director also works with the workers’ compensation management team on projects such as new-hire onboarding, compliance training, workflows, and best-practice audit follow-up. The role includes mentoring junior staff and helping identify their training needs. Travel is required about 10% of the time for occasional in-person claim reviews.

Requirements

At least 5 years of workers’ compensation claims handling experience.
A high degree of specialized and technical competence in claims handling, with emphasis on hands-on file management.
A college degree or equivalent business experience.
Ability to work independently and assimilate learning materials on a range of subjects from various sources.
Excellent interpersonal communication, computer, and negotiation skills.
Ability to deal with customers professionally.
Exceptional organizational, prioritization, and time-management skills.
Open communication style that supports continuous learning and team collaboration.
Advanced teamwork, collaboration, and account-management skills.
Outstanding written, oral, and presentation skills for a wide variety of internal and external customers.
Strong business acumen and understanding of claims fundamentals, underwriting, agency relationships, industry strategies, and trends.
High accuracy in claim financials and ability to explain the impact of claim transactions on internal and external customers.
Exceptional negotiation skills and ability to coach others in negotiation techniques.
Extensive knowledge of insurance contracts, investigation techniques, legal requirements, state compliance, and insurance regulations.

Responsibilities

Manage a senior examiner caseload involving severe exposures and complex coverage, compensability, litigation, or account management issues.
Apply advanced diary management, file documentation, action planning, reserve analysis, and exposure analysis skills.
Use internal and external resources to make appropriate, timely decisions independently and within authority.
Conduct high-level investigations or work with the Special Investigations Unit (SIU) to direct them.
Collaborate with medical resources to manage unusual injuries and treatment needs.
Address compliance issues and exposures.
Calculate and present significant reserves and settlements to internal and external customers.
Use effective settlement strategies that account for Medicare Set-Aside (MSA), structured settlements, and subrogation issues.
Use technical expertise and business acumen to handle account management issues.
Work with the workers’ compensation management team on projects such as new-hire onboarding, compliance training and workflows, and best-practice audit follow-up.
Mentor junior staff and help identify their training needs.
Manage claim financials accurately, including benefit issuance, bill payment, coding, reserves, and inventory management, and articulate the impact of claim transactions on customer interests.
Coach others in negotiation techniques.
Travel approximately 10% of the time for occasional in-person claim reviews.