Claims Director

Job Overview

Davies Insurance Services is looking for a Claims Director for the Accident & Health Audit Solutions division to audit Aggregate Stop Loss Claims.  The Accident and Health Audit Solutions division conducts approximately 100 audits annually involving the medical employer stop loss, captive, managed care, and life and disability markets.  The audits are of varying nature including stop loss (Aggregate & Specific), TPA, MGU/carrier, premium, and life and disability.  The ideal candidate will have the appropriate experience and demeanor to work independently in reviewing claims, underwriting and premium administrations at the reinsurance level.  This role will be a key part of the team, working within a global professional services and technology firm that prides itself on providing the highest standards of service to its clients and requires someone that aligns with Davies Group’s Big IDEA to Inspire, Deliver, Empower and Aspire. We can help you achieve lasting success in an energetic and positive environment.

 Responsibilities and Duties

• Accountable for independently performing aggregate claim audits
• Collaboratively working to assist lead auditors on high-level audit assignments
• Ability to draft audit reports with accuracy
• Communicate with clients, third-party administrators, and brokers in requesting required information
• Some travel required
• Manage time appropriately and multi-task efficiently
• Complete all audit work within expected timeframes

 Qualifications

• Knowledge and experience with auditing of stop loss claims
• Intermediate level MS Word and MS Excel experience

 Experience

• 5+ years of industry audit or stop loss claims experience

 Knowledge, Skills, & Abilities

• Superb communication skills, written and verbal
• Excellent analytical skills
• Effective interpersonal skills and willingness to adjust interactions based on targeted audience
• Exceptionally well organized and focused with a high level of attention to detail
• Collaborative communication with key stakeholders at all levels, internally and externally
• Driven to work independently as well as capable if working with colleagues
• Discretion when handling confidential information

 Essential Requirements

• Must have US work rights
• Industry audit or stop loss claims experience

Diversity & Inclusion

Davies is committed to being a diverse and inclusive workplace. We welcome candidates of all genders, gender identity and expression, neurodiversity, sexual orientation, disability, physical appearance, body size, race, age, nationality, and belief (or lack thereof).

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