Workers Compensation Large Loss Claims Director

Essential Duties & Responsibilities

• Oversees the most complex, high-exposure, catastrophic, and litigated workers' compensation claims.
• Serves as the technical authority on claim coverage, liability, compensability, exposure evaluation, reserving, and settlement strategy.
• Determines if a major claim should be settled or litigated and implements an appropriate resolution strategy accordingly.
• Effectively manages loss costs and claim expenses on major claims.
• Develop and execute resolution strategies that balance customer needs, claim outcomes, and cost management objectives.
• Direct complex investigations, litigation activities, discovery strategies, and settlement negotiations.
• Collaborate with staff and panel counsel to develop effective litigation and resolution strategies.
• Provide expert guidance regarding Medicare Set-Asides, Independent Medical Examinations, rated age evaluations, catastrophic injury claims, and other specialized claim issues.
• Review and provide direction on large loss claims across the organization.
• Ensure timely review and approval of reserve analyses and Large Loss Summary Reports.
• Identify emerging severity exposures and recommend claim transfers, disposition involvement, or specialized resources when appropriate.
• Lead and participate in formal claim roundtables focused on large loss claims, reserving accuracy, and resolution planning.
• Analyze complex claim trends and communicate actionable recommendations to senior leadership.
• Actively pursues and identifies ways to reduce inefficiencies in claims processes.
• Utilizes oral presentation and writing skills to escalate or efficiently communicate appropriate exposures to senior claims management and other internal business partners, as needed.
• Keeps current on state/territory regulations and issues industry activity and trends.
• May represent company in industry trade groups or other important events involving external business partners and clients.
• Serve as a mentor, coach, and technical resource for claims professionals, managers, and business partners.
• Responsible for special claims projects and presentations.
• Identifies trends in complex claims and settlement strategies and communicates to senior management.

Skills, Knowledge And Abilities

• The highest level of technical and product specific expertise, claims resolution skill and knowledge of insurance and claims principles, practices and procedures.
• Excellent communication, negotiation and presentation skills.
• Ability to effectively interact with all levels of CNA's internal and external business partners.
• Excellent analytical and problem solving skills, with the ability to manage multiple projects.
• Ability to exercise independent judgment to effectively evaluate and handle ambiguous situations and issues as well as analyze, distill and communicate important aspects of them succinctly.
• Creativity in resolving unique and challenging business problems.
• Ability to achieve results by taking a proactive long-term view of business goals and objectives.
• Knowledge of Microsoft Office Suite and other business-related software and company systems.
• Ability to embrace change and value diverse opinions and ideas.
• Ability to manage multiple projects.
• Ability to articulate complex claim facts, issues and analyses in concise presentations to business partners and management as well as in internal reports.

Education And Experience

• Bachelor's degree or equivalent experience.
• Professional designations preferred.
• Typically a minimum 10 years claims experience with proven track record of success.