Claims Director

Chubb•Alpharetta, GA

About The Position

The Claims Director handles a senior examiner caseload involving severity exposures and complex coverage, compensability, litigation, or account management issues. The role requires advanced claim file management, independent decision-making within authority, and effective use of internal and external resources. The Claims Director also contributes to the workers’ compensation management team through projects, mentoring, training support, and collaboration.

Requirements

Minimum of 5 years of workers’ compensation claims handling experience.
College degree or equivalent business experience.
High degree of specialized and technical competence in claims handling, with emphasis on hands-on file management.
Ability to work independently and assimilate learning materials on varied subjects from multiple sources.
Excellent interpersonal communication, computer, and negotiation skills.
Ability to deal with customers professionally.
Advanced organizational, prioritization, and time-management skills.
Strong teamwork, collaboration, and account-management skills.
Outstanding written, oral, and presentation skills for a wide range of internal and external customers.
Strong business acumen and understanding of claims, underwriting, agency relationships, industry strategies, and trends.
High accuracy in claim financials and ability to articulate the impact of claims transactions on internal and external customers.
Extensive knowledge of insurance contracts, investigation techniques, legal requirements, state compliance, and insurance regulations.

Responsibilities

Manage a senior examiner caseload involving complex coverage, compensability, litigation, and account management issues.
Apply advanced diary management, file documentation, action planning, reserve analysis, and exposure analysis.
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.
Apply 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, 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, and explain the impact of claim transactions on customer interests.
Negotiate effectively and coach others in negotiation techniques.
Travel occasionally for in-person claim reviews, approximately 10% of the time.