Directs the claims management function for Master Policy TLL and Contents Claims. Leads claims adjusters, oversees complex claim adjustment and settlements, ensures regulatory compliance, manages disputes and DOI complaints, represents the company in depositions, and improves departmental performance. The role also develops team capabilities, maintains external stakeholder relationships, and analyzes claims trends and operational metrics.
About Get Covered LLC
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.
- Dispute Resolution:
- 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.
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