Director, Client Advocates Claims

SUMMARY: The Claims Director, Client Advocates, is responsible for overseeing the claims advocacy team and managing the most complex and high-exposure claims. This role provides strategic direction for claims handling, ensures optimal outcomes for clients, and oversees the agency's largest accounts. The Claims Director acts as a coach, mentor, and trainer for the Claims Advocates and is instrumental in developing team members. This position also involves direct management of claims personnel and fostering strong relationships with clients, carriers, and other stakeholders.

WORK PERFORMED:

• Lead and mentor a team of Claims Advocates, providing coaching, training, and career development.
• Oversee the claims management process for the agency's largest and most complex accounts.
• Serve as the primary resource for escalated and high-exposure claims, providing expert guidance and resolution strategies.
• Develop and maintain positive relationships with clients, carriers, and providers to facilitate effective claims handling.
• Monitor and analyze claims trends to proactively address potential issues and ensure the best possible outcomes.
• Implement claims advocacy best practices to support clients throughout the claims process.
• Hold adjusters accountable for performance, responsiveness, and fair claim settlements.
• Conduct claims analytics, including reporting and trend analysis, to identify areas for improvement.
• Oversee Electronic Medical Record (EMR) management, projections, and reviews.
• Stay up to date on evolving insurance coverages and regulatory changes that impact claims management.
• Provide ongoing education and training for both internal teams and clients regarding claims processes and best practices.

JOB REQUIREMENTS:

• Proven ability to oversee and manage complex claims.
• Experience handling large commercial accounts and high-exposure claims.
• Strong leadership and mentoring skills with a track record of developing talent.
• Excellent analytical skills to assess claim trends and implement effective strategies.
• Proficiency in Microsoft Office, particularly Outlook, Word, and Excel.
• Deep understanding of personal and commercial insurance lines, claims principles, terminology, and best practices.
• Exceptional verbal and written communication skills with the ability to interact effectively with various stakeholders.
• Strong problem-solving and negotiation skills with a customer-centric approach.
• Ability to manage multiple claims cases efficiently while maintaining attention to detail.

PREFERRED EDUCATION/EXPERIENCE:

• 10 years of claims experience, with a focus on large or complex accounts.
• Experience in a retail Property & Casualty agency.
• Knowledge of Applied System's EPIC.
• Insurance and claims management designations and/or certifications are a plus.
• Bachelor's degree required

This role is integral to providing exceptional claims advocacy and ensuring the highest level of service for our clients. The Claims Director, Client Advocates, is a strategic leader who not only manages claims but also develops and supports the claims team to achieve excellence in claims management.