Director of Claims

Company Details

 

Midwest Employers Casualty (MEC) is a member of the W. R. Berkley Corporation, a fortune 500 company, rated A+ (Superior) by A.M. Best Company, based in Chesterfield, MO. We improve the quality of life for employees severely injured on the job and help companies understand and mitigate their risk for workers’ compensation injuries. MEC has a friendly, results-focused work environment. We seek employees who take initiative, are quick to adapt, are dependable, and like working as part of a team.

 

Company URL: https://www.mecasualty.com/                 

 

The company is an equal opportunity employer.

Responsibilities

MEC’s Claims Department leverages a multi-disciplinary claims team composed of claims analysts, medical management consultants, and legal professionals to optimize care and recovery of injured workers. The Director of Claims will oversee Regional Claims Managers and provide strategic technical direction. This role emphasizes leveraging technology to optimize reserving, cost containment, and settlement processes. The Director of Claims will ensure compliance with corporate policies, continuously improve claims procedures, and report directly to the Vice President of Claims.

 

Key functions include but are not limited to:

 

Team Leadership & Management

• Lead, mentor, and supervise Regional Claims Managers and their teams of Analysts and Examiners.
• Maintain appropriate staffing levels according to workload demands.
• Assist in identifying and selecting staff and oversee their ongoing training and development.

Strategic Improvement & Technology Integration

• Work with senior leadership to develop and refine claims handling models, processes, and workflows to maximize effectiveness and efficiency.
• Partner with Claims and IT business leads to identify and implement automation and data management enhancements.
• Evaluate and enhance standard operating procedures to drive innovation in claims handling and customer service.

Quality Assurance & Compliance

• Manage corporate quality assurance programs and align claims operations with strategic objectives.
• Conduct regular file reviews to ensure compliance with company standards and regulatory requirements.
• Stay updated on judicial legislative changes affecting claims handling and jurisdictional exposures and promptly communicate necessary adjustments.

Financial Oversight

• Address all reserving, payment, and settlement requests within the position’s authority.
• Develop and manage the annual expense budget for areas of direct responsibility, ensuring adherence to financial targets.
• Analyze and report on claims data to evaluate performance relative to established objectives and recommend corrective actions as needed.

Performance Management

• Utilize performance management and review processes to maximize staff effectiveness.
• Identify staff training needs and recommend targeted development solutions.

 

Claims Support & Resolution

• Oversee the investigation and resolution of assigned claims, ensuring efficient handling of coverage, exposure, subrogation/recovery, and settlement.
• Provide technical claims support to internal business partners.
• Ensure consistency in claims processes use of systems/applications, and customer experience.
• Lead regional claims teams to effectively resolve claims issues.

Collaboration & Communication

• Foster strong business relationships with insureds, brokers, TPAs, and internal stakeholders.
• Collaborate with underwriting, actuarial, and sales teams to align claims strategies with broader business objectives.
• Maintain exceptional oral and written communication skills, tailoring communications to varied audiences.
• Remain calm under pressure, demonstrating excellent organizational skills, integrity, and follow-through.

Qualifications

• Bachelor’s degree or equivalent work experience.
• At least 10 years of experience in workers’ compensation claims, with a minimum of 5 years in a supervisory or management role.
• Demonstrated experience managing a diverse team.
• Proven ability to build and maintain strong business relationships with various stakeholders.
• Superior time management skills, capable of triaging and prioritizing tasks effectively.
• Strong collaborative skills with internal and external teams.
• Exceptional communication skills, adaptable to various situations and audiences.
• Maintain technical and regulatory expertise in all assigned jurisdictions.
• Proactively investigate and resolve claims issues.
• Continuously seek opportunities to process improvement and implementation of best practices.
• Ensure compliance with legal statues, policy provisions, and company guidelines.

Additional Company Details

We do not accept any unsolicited resumes from external recruiting agencies or firms. 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.