Also referred to as:
Claims Processing Director, Claims Review and Settlement Director, Claims Service and Operations Director
Requirements and Responsibilities
Claims Director directs the operations of one or more claims units to ensure timely, accurate, and compliant claims handling. Oversees claims managers and supervisors responsible for investigation, evaluation, negotiation, and settlement activities. Being a Claims Director develops operational plans, productivity targets, and quality standards to meet financial and service objectives. Manages departmental budgets, staffing, and vendor relationships to optimize resources and control costs. Additionally, Claims Director ensures adherence to regulatory requirements, internal policies, and best practices across all assigned claims functions. Analyzes claims trends and reporting data to identify improvement opportunities and inform leadership decisions. Requires a bachelor's degree. Typically reports to senior management. The Claims Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. To be a Claims Director typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function.
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