Chief Claims Officer

Chief Claims Officer

Job Summary:

The Chief Claims Officer provides oversight, management, and guidance to ensure all claims handling and claims operational processes are conducted in compliance with applicable contracts, industry best practices, internal processes, and legal/regulatory requirements.

The position involves building and maintaining a claims department designed to minimize company risk, add value to internal constituents and external stakeholders, and enhance the Company's reputation in the P&C specialty insurance space.

Primary Duties/Responsibilities:

• Provide overall strategic oversight and leadership direction within including the development and execution of business and financial objectives
• Develop and enforce best practices for TPA diligence and on-boarding
• Report to management and UWC on recommendations
• Responsible for vendor and law firm management relating to claims matters, including TPA vendor approval process and panel counsel management
• Oversee referred claims by approving reserves, developing strategy, hosting round tables, etc.
• Coordinate with Legal on coverage issues and claim denials
• Ensure timeliness and integrity of data received from TPA and ability for client to digest/report
• Develop management and reinsurer reporting protocols, including KPIs
• Build and manage claims audit program and integrate into overall program
• Lead claims audits, in the field and remotely, as applicable
• Develop and manage client referral and approval process
• Develop claims compliance and claims handling policies in conjunction w/Legal and Compliance
• Align with Legal to advance contracting (and contract enforcement) efforts with TPAs
• Represent company in industry trade groups and other external constituents
• Support Ambac group strategic initiatives, including regarding M&A/investment activities and diligence on claims-related endeavors

Education, Experience, and Other Qualifications:

• Bachelor's degree in a related field, or equivalent work experience required
• Twenty(20) years' experience in P&C Claims
• Management experience