Complex Claims Liability Director – TPA Oversight

Role Overview

• Analyze and process bodily injury and third-party property damage claims by investigating and gathering information to determine the exposure on the claim;
• Ensure proactive claims handling aimed at the prompt and cost-effective resolution of claims through well-developed action plans.
• Determine need for and direct independent adjusters to gather information to determine exposure on the claim and control their costs.
• Identify and evaluate coverage issues;
• Prepare comprehensive coverage letters with supervisory review and analysis;
• Retain and provide direction to coverage counsel when necessary.
• Assess liability and resolve claim within established evaluation.
• Maintain diaries and complete tasks within required timeframes as set forth by department guidelines;
• Ensure claim files are timely and properly documented with clear and concise analysis on coverage, damages, reserves, and liability including an action plan for resolution.
• Process and pay invoices within a timely manner.
• Coordinate vendor referrals for additional investigation and/or litigation management.
• Calculate and assign timely and appropriate reserves; monitor reserve accuracy throughout the life of the claim.
• Refer case as appropriate to supervisor and management.
• Respond to requests or directions in a professional and timely manner.
• Attend arbitrations, mediations, settlement conference and trials.
• Successfully complete required State licensing examinations and continuing education requirement.
• Communicate with all internal business partners including underwriters to make sure underwriting is aware of large losses and industry trends.
• Partner with TPA Governance and Relationship Management to help TPA’s and Insureds comply with claim handling and reporting guidelines.
• Work with TPA Claims Financial to check the accuracy of TPA financials ensuring alignment with TTPO financials.

Requirements

• 7 plus years of General Liability/Auto claims experience.
• Experience with complex and high exposure General Liability Bodily Injury and Property Damage claims.
• Excellent communication skills (verbal/written) and strong negotiation skills.
• Advanced experience and capabilities in litigation claims management, including ADR and mediation processes, involving auto/GL exposures.
• Strong technical expertise interpreting insurance contracts.
• In depth knowledge of claim handling procedures, claims performance strategies, and claim best practices.
• Advanced analytical and problem solving skills.
• Should also have a demonstrated ability to initiate and champion change initiatives that leverage technology and improve skills in benchmarking.
• Creativity in resolving challenging business problems, as well as ability to achieve business goals and objectives is essential.

Benefits

• Competitive salary
• Health insurance
• 401(k) matching
• Flexible working hours
• Paid time off
• Professional development opportunities