Group 1001 · 13 hours ago
Vice President, Claims
United States
Full-time
Remote
Director/Executive
$180K/yr - $225K/yr
15+ years expGroup 1001 is a consumer-centric, technology-driven family of insurance companies focused on delivering outstanding value and operational performance. The Vice President of Claims will lead the claims management process, overseeing technical, operational, and administrative functions while ensuring compliance and exceptional service.
FinanceFinancial ServicesInsurance
Responsibilities
Lead all aspects of claims management for the organization
Responsible for technical, operational and administrative claims functions including reserving practices
Select and manage performance of Third-Party Administrators, Managed Care and other claims vendors
Oversee transitions/implementations of new claims TPAs
Manage key department-wide function(s) such as training, talent development, and change management
Lead and direct the claims management process, driving execution of best practices and related initiatives to reduce the total costs of claims, while providing exceptional member service
Provide the highest levels of technical direction to the adjuster team on significant claims and complex coverage issues
Establish Key Performance Indicators (KPIs) for all areas of claims operations, design reports to capture same, review and analyze monthly data and direct corrective actions where required
Manage and report on the quality assurance processes to evaluate the TPAs and defense panels’ adherence to claims handling standards
Ensure case reserves are consistent with our guidelines and philosophy. Monitor actual reserves to confirm accuracy
Prepare reports for Executive Leadership Team and lead review and discussion of same
Directly oversee the TPAs’ activities on workers’ compensation, commercial auto, and general liability claims
Establish and extend authority levels on all referred claims
Select, train and manage staff where necessary
Provide technical support to internal business partners, including underwriting, finance, and actuarial
Oversee the performance of claim audits quarterly
Track and analyze ALAE to ensure effectiveness and efficiency
Ensure claims are adjusted in accordance with applicable State laws and regulations
Oversee and analyze cost containment mechanisms (early reporting, directing injured employee to preferred provider, utilizing preferred pharmacy, etc
Pursue prompt and accurate closure of claims
Manage claims reporting responsibilities for state agencies and reinsurers
Represent the company on claims-related matters with external business partners
Qualification
Required
15 or more years of work experience in an insurance company claims department or TPA
Advanced skills in coverage and insurance policy analysis, litigation management principles, investigative and negotiation techniques
Strong organizational skills and detail oriented
Ability to work independently and handle multiple tasks simultaneously
Strong working knowledge of Workers' Compensation, Auto Liability, General Liability, Professional Liability and Employer Liability claims
Excellent verbal and written communication skills
Excellent customer service and collaboration skills
Extensive knowledge of P&C regulations and applicable law
Extensive knowledge of insurance contracts and adjusting techniques
Familiarity with medical terminology, legal procedures, and claim evaluation
Demonstrated leadership, coaching, influencing, and teamwork skills
Computer literacy, including working knowledge of MS Office Product Suite, i.e. Word, Excel, PowerPoint
Previous supervisory experience required
Strong vendor management skills
Benefits
Comprehensive health, dental, and vision insurance plan options
Basic and Supplemental Life Insurance
Short and Long-Term Disability
Employee Assistance Program
Wellness programs
401K plan, with matching contributions
Company
Group 1001
Group 1001 is a collective that empowers companies to create positive growth. Our insurance and annuities are easy to understand and accessible to all.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Tony Marichal
VP of Annuity Operations
Mark McCallister
Chief Internal Auditor
Recent News
2025-08-08
2025-07-09
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2024-12-04
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