Director, Senior Care Claims

Berkley Healthcare Director Of Claims

As a member company of W. R. Berkley Corporation, Berkley Healthcare has assembled a unique team of multi-disciplinary insurance professionals to take a fresh look at healthcare organization insurance. We pride ourselves on our deep expertise in underwriting, claims and distribution in the healthcare industry insurance market. We understand that the healthcare industry is in a state of rapid evolution; shaped by emerging concepts in technology, law, public welfare and social economics, all with attendant enterprise risk unique to healthcare organizations. We apply cutting-edge insurance concepts to traditional healthcare insurance products that embrace the current complexity of the healthcare industry and give ultimate flexibility in managing enterprise risk.

The company is an equal opportunity employer.

Responsibilities

The Director will be part of a small team of claim professionals responsible for managing a full inventory of Senior Care Professional and General Liability claims with varying levels of exposure. The Director will be responsible for overseeing all aspects of claim handling, including determining coverage, investigating liability and damages, evaluating and resolving claims, and managing complex litigation.

Hybrid Model Mon-Thurs in office, Fri-work from home. If you are over 50 miles from one of our offices, the role can be Remote for the right qualified candidate.

Key functions include but are not limited to the following:

• Manage a full inventory of Senior Care Professional and General Liability claims with varying levels of exposure.
• Comply with Best Practices guidelines and other company claim handling requirements regarding communication, investigation, litigation management, coverage evaluation, exposure assessment, and settlement/resolution.
• Evaluate and verify coverage by reviewing and interpreting the claims asserted alongside applicable policy language.
• Investigate liability and damages, retain qualified counsel as necessary, and set appropriate and timely reserves that are consistent with estimated exposures.
• Develop and execute a claim resolution strategy, taking into account the unique and individual characteristics of the claim, communicating and collaborating with stakeholders as appropriate.
• Present claims clearly and concisely to senior leadership as requested.
• Travel as needed to mediations, settlement conferences, trials and other proceedings.
• Contribute to a collaborative environment by raising new ideas, demonstrating teamwork, high motivation, positive behavior and effort to achieve goals and objectives.
• Build and maintain productive relationships with internal and external customers, including clients, underwriters and agents.
• Engage in projects or other responsibilities/tasks outside of direct claim handling.
• Actively self-educate as to line of business, industry and insurance trends including exposures, claims, legal, legislative, healthcare, current events, self-improvement and innovation.

Qualifications

• Bachelors' degree required. JD preferred.
• Minimum of 5-7 years' claim handling or other relevant work experience
• Experience managing senior care claims preferred
• Adjusters' licenses will be required for the successful candidate
• Self-motivated, independent and decisive
• Excellent time management skills with ability to triage and prioritize
• Exceptional collaboration with internal and external teams and partners
• Willingness to learn/develop coverage concepts/issues in the required lines of business
• Strong oral and written communication skills with ability to articulate very complex facts, analysis and recommendations in a concise manner to senior leadership, insureds, and external business partners
• Desire for new and varied job responsibilities beyond claims handling
• Demonstrated ability to meet deadlines, determine priorities and adapt to changing priorities as needed.

Additional Company Details

We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role include: • Base Salary Range: $125,000 – $160,000 • Eligible to participate in annual discretionary bonus. • Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.

Sponsorship Details

Sponsorship not Offered for this Role