Director of Claims
About the Role
The Director of Claims is responsible for developing and implementing claims management services for healthcare organizations which include hospitals, physician groups, and other related healthcare facilities. As the department leader, you lead internal claims operations, maintain control over all open claims, and review & manage all potential compensatory events.Job Specs
Location: Remote, work-from-home position within the Mountain West, Southwest, or Midwest. Your territory includes Montana, Idaho, Wyoming, & New Mexico. Expect travel to see clients in those four states.
Duties & Responsibilities
- Direct and coordinate claims activities including investigation, reporting, and resolution.
- Establish and maintain reserves.
- Determine actions to be taken on coverage questions and/or obtaining policy interpretations.
- Authorize and approve the extension of coverage, reservation or rights, denials of liability, settlement, and payments within established limits of authority.
- Review medical records and pertinent damage information for case value and exposure.
- Recommend appropriate payment of attorney, expert witness, related fees, and cost reimbursement.
- Manage litigation and settlement of claims within established limits of authority. Participate in dispute resolution forums, settlement conferences, and trials.
- Report claims activity, reserve changes, and loss/LAE information to reinsurers.
Skills & Experience
- Bachelor’s degree and completion of, or actively pursuing, AIC or other related claims certification course
- Five (5) years of Medical Professional Liability claims experience with at least two (2) years of supervisory experience
Target compensation range of $90k to $100k depending on experience