Director of Claims (Employer Stop Loss)- Remote

Crum & Forster Company Overview:

Since 2000, Crum & Forster’s Accident & Health division (A&H) has offered a diverse portfolio of specialty insurance and reinsurance products nationwide. We place a strong focus on product development and creative distribution methods, along with excellent client service and support.

In addition to our robust domestic portfolio, which spans both special risk and medical solutions, A&H works on an international basis through various partnerships. Our global capabilities provide our partners with even broader flexibility in underwriting solutions.

The qualities and capabilities of Crum & Forster Accident & Health demonstrate our philosophy of building meaningful, long-term partnerships and our dedication to providing alternative strategies in an ever-changing insurance market.

The A&H MBU takes a full-spectrum approach to designing and servicing a robust slate of products tailored to needs in Employer Stop Loss, Excess Medical, Life, and Ancillary and Supplemental benefits. Our diversified business model includes program partnerships as well as direct sales in Employer Stop Loss. At year-end 2023, the MBU recorded $741M in gross premium written.

Information about the Role, Line of Business and Team:

The successful candidate will work as part of the Stop Loss team to proactively manage a team of claims professionals including intake and adjudication functions while creating, implementing and managing a long term strategy that aligns the claims team to the division’s objectives.

What you will do:

• Develop long term plan for claims organization as the division continues its growth path
• Establish and monitor benchmarks and metrics for team performance
• Develop and provide innovative solutions that provide strategic impact to the division
• Cultivate and maintain excellent relationships with reinsurers, business units and client partners
• Establish, negotiate and maintain vendor relationships and contracts that have a direct impact on divisional results
• Identify strengths and weaknesses of team, process and plan and act as required
• Collaborate with management team on planning, staffing and budgeting
• Manage audit process that integrates meaningful quality standards, validates appropriate controls and provides value to the division and client partners
• Work with vertical partners to ensure alignment with divisional objectives and standards; on an ongoing basis monitor that alignment
• Manage assignment of work/division of responsibilities to ensure that client needs are being met and response times managed to standards
• Provide direction to staff on litigated, complex and potential high exposure claims
• Prepare detailed reports summarizing results of risk management reviews of specific clients as needed but no less often than monthly
• Prepare portfolio analysis summary reports for delivery to management in Operations and the Business Unit on a monthly basis
• Identify persistent claims error trends and report those trends immediately to management
• Ensure that all Claims administrators are informed of and in adherence to applicable state unfair claims practices laws
• Work with Claims team to ensure that all customer interactions are documented using appropriate tools with strict adherence to confidentiality agreements, policies and procedures.
• Work with Claims team, Direct team and verticals to ensure that the process to monitor claim denials Is consistent across the division and being handled within guidelines, consistent with policy provisions and clearly, professionally and courteously communicated to the certificate/policyholder
• Aggregate accommodation
• Strategic Business objectives
• Reserves
• Monthly reporting
• Team management
• Other duties as assigned

What YOU will bring to C&F:

• Highly experienced with all facets of client relations
• Strong people management skills
• Excellent oral and written communications skills
• Proficient in the use of MS Office including Word, Excel and Access
• Ability to successfully manage multiple projects and clients simultaneously
• Ability to work independently
• Demonstrated problem solving ability
• Strong attention to detail

Requirements:

• Minimum 10 years’ experience in Property & Casualty or Accident &Health products in any combination of carrier, TPA or MGU environment;
• 5 years’ experience managing people
• Ability to travel

• Competitive compensation package
• Generous 401K employer match 
• Employee Stock Purchase plan with employer matching
• Generous Paid Time Off
• Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family’s wellness including your physical, mental and financial wellbeing
• A core C&F tenant is owning your career development so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry related certifications and professional training to keep you progressing on your chosen path
• A dynamic, ambitious, fun and exciting work environment
• We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee driven corporate giving program that lets you participate and support your community

At C&F you will BELONG:

We value inclusivity and diversity. We are committed to equal employment opportunity and welcome everyone regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status. If you require a special accommodation, please let us know.

For California Residents Only:  Information collected and processed as part of your career profile and any job applications you choose to submit are subject to our privacy notices and policies, visit https://www.cfins.com/onlineprivacypolicy/ca/noticeatcollection/ for more information.

Crum & Forster is committed to ensuring a workplace free from discriminatory pay disparities and complying with applicable pay equity laws.  Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions. The annualized base pay for the advertised position, located in the specified area, ranges from a minimum of $82,500.00 to a maximum of $155,100.00. The actual compensation is determined by various factors, including but not limited to the market pay for the jobs at each level, the responsibilities and skills required for each job, and the employee’s contribution (performance) in that role. To be considered within market range, a salary is at or above the minimum of the range. You may also have the opportunity to participate in discretionary equity (stock) based compensation and/or performance-based variable pay programs.

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