Assistant Director of Claims Administration

Department Information

Description of Job

Duties and Responsibilities:

Claims Investigation, Adjudication and Resolution

• Maintain an active property and casualty claims inventory in addition to oversight of multi-line property, casualty and workers’ compensation claims operations and staff performance.
• Strategically serve as backup for property, casualty, and workers‘ compensation claims team members to support workload management and coverage needs.
• Provide direct claims and litigation management, including insurance coverage application for all liability lines of coverage (including but not limited to, general liability, international, property, cyber, and life sciences).
• Coordinate and assist university legal counsel in assessing coverage application and campus financial participation when applicable. Includes collaboration, communication, and negotiation of payment and denial of claims with campus leadership.
• Continually identify claim coverage gaps and provide information to URM leadership for assessment of coverage lines.
• Provide analysis of insurance policies for the determination of coverage for losses sustained.
• Direct and participate in the claim’s investigation process for all lines of coverage, when needed, including on-site activities with university campus personnel.
• Analyze exposures, establishes claim reserve funding requirements, and manages appropriate reserve funding levels consistent with insurance industry best practices.
• Overall coordination of claims investigation, reviews, diaries, reporting, analysis, and closure of claims for self and other staff, as needed.
• Ensure quality and accuracy of the claim unit’s work product, including audit of claim files for compliance with applicable laws, statutes, and claim management guidelines, adjusting processes as necessary.
• Develop claim status communication (denial, payment, settlement) for URM-directed claims, including CGIA and liability analysis, to stakeholders and counsel.
• Assist and report claims appropriately to federal and state agencies when applicable (SSI, Medicare/Medicaid).
• Understand applicable laws and regulations as they relate to various claims and insurance triggers for coverage - including privacy laws.
• Review contracts and recommend language designed to mitigate claims and insurance risk exposure.

Legal and External Partner Coordination

• Evaluate and direct outside law firm representation in coordination with assigned university legal counsel to obtain maximum services while managing cost and to ensure continuity with developed loss control plans.
• Administer the interactive relationship with excess insurance carriers to guarantee coordination and commitment to losses, exposure control, and to comply with contractual obligations - including timely reporting of claims.
• Represent CU’s captive and self-insurance program at mediation meetings, State and Federal court dispute resolution hearings, and Judge Advocate General Hearings, with the appropriate authority to settle claims.

Claims Staff Support

• Develop and recommend claim management policies and procedures in support of university objectives and goals to strategically manage costs.
• Assists in the evaluation of the claims management system and guides the use of the system, as well as recommending additions and changes to functionality based on the changing claims environment.
• Supports claims staff in developing claims strategies and execution.
• Develop a continuing education program for claims staff, providing opportunity for them to become multi-line proficient claims professionals.
• Create and integrate cross-training opportunities for claims staff across coverage lines to strengthen continuity of operations, maintain service levels and responsiveness, and support the development of technical skills needed for career advancement.

URM Staff Support

• Provides expertise to campus URM Directors in the interpretation of insurance policy coverages as relates to claims.
• Aids campus URM Directors in the reporting and evaluation of claims trends and opportunities for loss prevention or training.
• Represents URM to campus personnel and provides claims overviews to stakeholders on claims trends and metrics.
• Participate in committees to provide technical risk management expertise directly related to claims when requested.
• Counsel and provide support to campus personnel regarding post- incident control and advise on the restoration to normal activities.
• Provide support to the risk management professionals at each of the system campuses, including exposure identification, training, contract review, outreach programs, and other strategies to minimize risk.

Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights

Minimum Qualifications:

• Bachelor’s degree in business, risk management, safety, or related field (professional experience may be substituted on a year-for-year basis).
• Seven (7) years progressively responsible experience in insurance, some combination of property, casualty, and workers’ compensation claims or related field with emphasis on liability claims.
• Four (4) years of experience and proficiency in adjudicating litigated, property and casualty claims with emphasis on liability claims.
• Three (3) years of leadership experience, which may be in a managerial or supervisory role, leading projects and large initiatives, and/or project management skills, and working with high-level leadership.
• Demonstrated success managing and leading in a complex organization.
• Demonstrated high level of commitment to customer service and team development.
• Current Colorado driver’s license, vehicle, and insurance and ability to travel throughout the area to all CU campuses and locations.
• Flexible hours as this position is required to respond to urgent requests and situations that may fall outside of the standard work week and could include holidays.

Preferred Qualifications:

• Bachelor’s or post-baccalaureate degree in business, risk management, safety, legal or related field.
• Three (3) years of experience in higher education and/or Colorado public entity claims or risk management.
• Ten (10) years progressively responsible experience in insurance, all lines property, casualty and workers’ compensation claims, or related field with emphasis on liability claims.
• Seven (7) years of experience and proficiency in adjudicating litigated, property and casualty claims, with emphasis on liability claims.
• Five (5) years of management/supervisory experience of one or more employees.
• Professional claims, insurance or risk management designation (ARM, AIC, SCLA, CCP, CRM or CPCU or similar).

Supplemental Information

How to Apply:

For full consideration, please attach the following as separate documents to your application at https://cu.taleo.net/careersection/2/jobdetail.ftl?job=39917:

• A cover letter identifying the job specific minimum qualifications you possess and interest in the position.
• A resume including all relevant experience to be accurately assessed against the qualifications listed in the posting.

Benefits:

With our unparalleled range of benefits, including top-notch healthcare, comprehensive wellness programs, enriching professional development, and a dynamic work-life balance, we ensure your holistic growth and happiness.

• No-cost or low-cost medical & dental plan options, some inclusive of IVF assistance.

• Disability, Life, Vision Insurance options.

• Multiple retirement planning options including a mandatory 401(a) plan where CU contributes 10% of your gross pay, a 401k or 403b plan and a 457 deferred compensation plan.
• Pre-tax savings plans, such as Health care and Dependent care flexible spending accounts.
• Embrace a healthy work-life balance with ample sick and vacation leave, along with at least 12 paid holidays. This includes a dedicated week off for winter break.
• 6 weeks of parental leave to adjust to the joys of parenthood.
• A tuition benefit program for you and/or your dependents.
• Free RTD EcoPass and free onsite parking at our 1800 Grant Street Office.
• Many additional perks & programs with the CU Advantage.

Additional taxable fringe benefits may be available.

For more information on benefits programs, please review our Comprehensive Benefits Guide.

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