Director of Claims - Fond du Lac, United States - Society Insurance Company

Society Insurance Company

Verified Company

Fond du Lac, United States

2 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

Job Information

Job Title
Director of Claims (Technical and Shared Services)

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Home Department:

Claims

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Employment Status:

Exempt; Full-time

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Schedule:
40 hours/week with Flexible Scheduling Opportunities
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Position Location
Flexible Remote Work/Hybrid Scheduling-
_ Overview_
Protecting our policyholders' dreams, passions, and livelihoods has a direct impact on the communities we serve. We work towards excellence, conduct ourselves with high integrity, and take our work seriously, but not ourselves. Small Details. Big Difference. Find out how you can make a difference with a career at Society.

Society Insurance is seeking a
Director of Claims (Technical and Shared Services) to lead a team dedicated to providing shared resources to the Claims teams.

These resources include, but are not limited to, claims services team, Medicare, subrogation, auditing, compliance, and data & analytics.

This position will be responsible for the development and administration of policies, procedures, and management of all claims functions in order to achieve the company goals for loss adjustment expenses, claims severity, customer service, policyholder retention, and company profitability.

The Director of Claims will set a positive cultural environment where integrity and ethics are unquestioned, customers are the prime focus, employee growth and engagement are present, and organizational excellence is the ultimate objective.

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About the Role_**- Aligns roadmaps with agile teams to advance the quality and effectiveness of claims handling through data collection/analytics, continuous improvement, and efficiency gains.

Establishes effective cost-containment programs and manages vendor relationships.

Engages claims leadership to establish project priorities across the department, understands key interdependencies among projects throughout the organization, and communicates testing needs.
Aligns resources to effectively deliver a businessrelevant solution within the constraints of scope, quality, time, and cost to the business documented requirements and project vision.
Supports and promotes agile planning methodologies as a valuable way to consistently create, deliver, and implement a businessrelevant software solution.
Works with Change Management to develop communication tools to highlight success stories while keeping the staff advised on claimspecific initiatives and/or training opportunities.
Engages managers, claims business leads, and SMEs in the claims department to identify continuous improvement opportunities and streamlines current processes that will support future growth. Ensures alignment among claim units including upstream and downstream dependencies and communicates hurdles and resource needs.
Develops and manages the claims functions including but not limited to: claim compliance, claim and suite file audits, department training, external audits, adjuster manual updates, and other resource needs. Supports team with complex coverage and loss questions.
Develops and presents claimsrelated training programs. Oversees the creation and maintenance of training documentation and assists in training on claims system enhancements.
Assists Claims Managers with monitoring of regulatory and compliance requirements for each state; assists implementation of requirements, and conducts claims staff training regarding requirements.
Establishes project priorities and understands interdependencies throughout the organization. Oversees the daytoday maintenance (break/fix) of department claims systems.
Works with Commercial Underwriting and Sales regarding state expansion to determine the metro areas being targeted and identify how Claims will support growth and profitability.
Seeks opportunities for straight through processing (STP) that will continue to advance the innovation and continuous improvement of Claims.
Works with key team members and department SMEs to implement training plans for maintaining claims files and Medicare. Oversees auditing process that aligns with State and Federal Medicare and Fair Claims Practices of each state Society conducts business in.
Supports an open and transparent environment, where new ideas surface easily, favorable change is embraced, and where leadership abilities are recognized and encouraged.
Coaches and develops high potential employees through superior talent development plans.

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About Yo_
u

You enjoy coaching and developing others within a collaborative team environment.
You are decisive and takes a systematic approach to continuous improvement initiatives.
You enjoy empowering and motivating others to achieve their full potential.
You encourage ownership of the company's mission, goals, and values.
You hold yourself accountable and am results driven.
You enjoy analyzing, investigating, and using the facts to make decisions.

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What it Will Take_**- Bachelor's degree in business, insur