Claims Director, Personal Injury Protection

Overview:

You will work independently and collaboratively with senior leadership to deliver innovative claims handling, reporting, and expense management improvements. This position reports to the Vice President of Claims.

Key Responsibilities:

• Own severity, service, and expense management for the Personal Injury Protection (PIP) line of business.
• Enforce company guidelines and procedures, maintaining a working knowledge of NY, NJ, MA, CT, NH, and PA regulatory claim handling guidelines and statutory requirements.
• Provide strategic direction for business processes, metrics, and budgeting related to the PIP operation.
• Implement changes across business units to improve productivity and operational efficiency, collaborating with other directors to achieve shared goals.
• Utilize metrics and reporting expertise to implement, analyze, and present performance reports on a weekly, monthly, and quarterly basis.
• Analyze complex data to drive recommendations for improving severity and expense outcomes.
• Deliver innovative ideas to enhance the claims operation and improve customer service for agents and policyholders.
• Communicate company goals, promote a problem-solving culture, and provide clear leadership to staff at all levels.
• Ensure compliance with industry best practices, state regulatory guidelines, and company policies.
• Manage expenses by monitoring current spending and implementing process improvements to reduce costs.
• Investigate and apply appropriate coverage policies for accurate assessment of PIP claims.
• Collaborate with other departments and senior management to resolve escalated issues and deliver optimal efficiency.
• Prepare and present written and oral reports to executive leadership on significant claim exposures, coverage determinations, and reserve recommendations.

Qualifications:

• Bachelor’s degree from an accredited college or university, or equivalent claims management experience.
• 7-10 years of experience in claims management with a strong background in PIP, Med Pay, medical bill adjudication, and litigation.
• Strong technical expertise in claims handling, with a proven ability to manage large-loss exposures.
• Excellent written and verbal communication skills, with the ability to present and influence senior leadership.
• Insurance designations (AIC, AEI, CPCU) are a plus.
• Proficient in Excel, with the ability to develop charts, pivot tables, and reports (Tableau experience is a plus).

Preferred Skills:

• Experience collaborating with Special Investigations Units (SIU) for fraud detection, major case initiatives, and mitigation.
• Strong analytical skills, with the ability to interpret complex data and reports to drive decision-making.
• Ability to handle multiple projects and responsibilities concurrently, with a focus on delivering results.

About the Company

Plymouth Rock Assurance Corporation holds an A.M. Best rating of “A-/Excellent”.

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