Regional Workers' Compensation Claims Director

This is a fully remote position, open to applicants in United States.

📋 Description

• Lead and cultivate a regional Workers’ Compensation claims team, ensuring prompt, precise, and customer-centric claim resolutions.

• Offer expertise on coverage, compensability, reserving, loss exposure, and strategies for resolving complex and high-exposure claims.

• Assess reserve sufficiency and claim results, ensuring adherence to reserving guidelines, best practices, subrogation, and recovery opportunities.

• Perform audits of claim files, authorize claims within designated authority, and address any customer or regulatory complaints.

• Supervise litigated claims by evaluating counsel performance, litigation strategies, settlement possibilities, and compliance with litigation protocols.

• Oversee the relationships and performance of independent adjusters, legal professionals, and vendor partners.

• Recruit, mentor, develop, and assess team members, including managing performance and planning for succession.

• Promote a collaborative, innovative, and inclusive culture within Claims and across business partners.

• Collaborate with Underwriting, Risk Improvement, Risk Services, Marketing, agents, and insured parties to discuss claim activities, trends, and significant updates.

• Manage departmental budgets and expenses, including ALAE, ULAE, staffing, and travel, while supporting profitability targets.

• Ensure adherence to state and federal regulations, licensing requirements, inquiries from insurance departments, and market conduct examinations.

• Create operational and claims performance reports, engage in strategic initiatives, and contribute to claims operations planning and analysis of industry trends.

⛳️ Requirements

• Bachelor’s degree or equivalent relevant experience.

• A minimum of ten years of experience in workers’ compensation claims handling in progressively responsible positions.

• Previous management experience is required.

• Insurance designations such as AIC, CIC, AIM, and CPCU are preferred.

• Capability to obtain necessary state licenses.

• Extensive knowledge of claim functions.

• Strong analytical skills and understanding of legal liability and coverage.

• Exceptional leadership qualities with the ability to inspire staff in managing and resolving claims.

• Comprehensive understanding of insurance contracts and the legal aspects of court procedures related to workers’ compensation insurance liability.

• Commitment to maintaining high professional conduct standards while delivering exceptional claims service.

• Proficient in computers and claims management systems.

• Excellent organizational and written and verbal communication skills.

• Strong investigative and problem-solving capabilities.

• Willingness to travel occasionally.

• A valid driver’s license with an acceptable motor vehicle report per company standards is necessary if driving is involved.

🏝️ Benefits

• Comprehensive benefits package including life, medical, dental, vision, and prescription drug coverage.

• Competitive paid time off plan.

• Full day of volunteer time off each year.

• 401(k) plan with matching contributions.

• Pension plan.

• OneEMC bonus program.

• Recognition and awards for service anniversaries.

• Opportunities for professional development and career growth.

• Tuition reimbursement available.

• Wellness programs designed to enhance team member well-being and lower health insurance costs.

• Flexibility in dress code to suit your day.

• Options for alternative work arrangements.