Claims Director

Alternate Locations: Charlotte, NC (North Carolina); Omaha, NE (Nebraska); Work from Home

 

 Work Arrangement:

Hybrid Preferred : Preferred employee will work 3 days a week in a Lincoln office

 

Relocation assistance:  is not available for this opportunity.

 

Requisition #: 74680

 

The Role at a Glance

 

We are excited to bring on a highly motivated Claims Director to our Claims Organization! 

 

•    As a Claims Director, you will provide leadership and direction to group of front-line managers and their direct reports.  You will manage will oversee and ensure the fair, ethical and timely management of complex claims for your assigned area(s) of responsibility.  You will also be directing and providing leadership to continually improve the capability and results and enhancing organizational initiatives by positively influencing and supporting change management and/or departmental/enterprise initiatives within your assigned area(s) of responsibility. 

 

•    This individual will need to be passionate about service and have the ability/desire to drive change while maintaining a strong sense of empathy. 

What you'll be doing

•    Maintaining knowledge on current and emerging developments/trends for assigned area(s) of responsibility, assessing the impact, and collaborating with management to incorporate new trends and developments in current and future solutions.
•    Identifying and directing the implementation of process improvements that significantly reduce workloads or improve quality across the department for their assigned area(s) of responsibility.
•    Providing subject matter expertise to team members and internal/external stakeholders on complex assignments/projects for their assigned area(s) of responsibility.
•    Providing training and development opportunities, including stretch assignments, for team members and gives honest and open feedback to aid in the development of talent.
•    Directing and evaluating individual/team performance and takes appropriate action to meet and/or exceed performance standards for assigned area(s) of responsibility.
•    Establishing and implementing priorities, performance goals and objectives to ensure group results for your assigned area(s) of responsibility.
•    Building organizational capability and ensuring that top talent is hired and retained for your assigned area(s) of responsibility.
•    Directing the processing and administration of all aspects of complex claims for your assigned area(s) of responsibility ensuring accurate and timely claim management.
•    Developing and executing claim initiatives which have substantial impact on the success of claims handling, enhance the customer experience and successfully meet the annual business operating priorities.
•    Monitoring and assessing trends in claims, identifying opportunities, and implementing industry leading, best practices to enhance the customer experience and improve claim management effectiveness.
•    Monitoring and implementing claims policy and guidelines in compliance with claim objectives and insurance laws and regulations.
•    Developing, maintaining, and analyzing appropriate metrics and control mechanisms for claims including using data and analysis to improve business results by targeting opportunities and process improvements within claims.
•    Approving and making complex claim management related financial decisions consistent with company guidelines for your assigned area(s) of responsibility.
•    Providing subject matter expertise and technical guidance to claim team members on claims adjudication for your assigned area(s) of responsibility.
•    Reviewing and resolving complex escalated issues and concerns for your assigned area(s) of responsibilities.
•    Ensuring all assigned area(s) of responsibility claims eligible or ineligible for payment conform to quality, production standards and specifications.
•    Ensuring claims processing is consistent with applicable policies, procedures, and department guidelines for your assigned area(s) of responsibility.
•    Developing and maintaining close customer ties, articulating customer needs, keeping priorities in focus with the desires and expectations of the customer.
•    Collaborating with internal and/or external stakeholders to ensure effective service delivery of more complex claims for your assigned area(s) of responsibility.
•    Ensuring regular quality audits of for your assigned area(s) of responsibility claim team member’s work.
•    Developing, managing, and overseeing the budget for your assigned area(s) of responsibility

What we’re looking for

Must-haves: 
•    4 Year/Bachelor’s