Claims Technical Director - TPA Oversight

Skyward Specialty is a property and casualty insurance holding company formed in 2007. Based in Houston, Texas, and with staff throughout the country, Skyward Specialty provides admitted and non-admitted solutions to retail and wholesale distributors, managing general agents and captive markets. We have built highly respected businesses in specialty lines including management professional liability, medical stop loss, surety, E&S property and liability, and large commercial property, as well as multi-line solutions for the energy, trucking and construction industries.

At Skyward Specialty, we approach this business differently. In fact, we’re different from most others in our industry in just about every way. We have the spirit of a start-up with the security of over $1.7 billion in Written Premium. We put immense brain power and energy into finding greater insights to uncover better opportunities for our clients, partners, and people. We think at a higher level, so they can succeed at a higher level.

We are committed to a Diverse Workforce

Skyward Specialty is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, nativity, neurodiversity, genetics, disability, age, or veteran status. For more information about us please visit www.skywardinsurance.com

Summary

The Claims Technical Director - TPA WC oversight for Claims in a Captive and Programs business. Reviews and provide direction on reserve and settlement authority, where required, on complex, specialized claims and/or high exposure claims primarily auto and general liability.  Supports business partner through communication about specific claims, identification of claim trends, input on development, and marketing support.  Monitors claim quality and customer feedback to ensure compliance with regulatory requirements, customer satisfaction and the achievement of corporate objectives. Independently operates within broad company guidelines and authority levels.

Principal Duties and Responsibilities

• Ensure proper reserves to achieve compliance with corporate policy.
• Management of WC TPA relationship and oversight of WC TPA handled claims, providing guidance with respect to coverage, investigation, and evaluation, ensuring compliance with best practices, and conducting WC TPA file reviews and audits.
• Conduct WC TPA file reviews and audits, as required.
• Conduct Internal file reviews and audits, as required.
• Oversight of complex and high exposure WC claims in litigation, including strategizing with defense counsel, TPA adjuster and experts on defending such.
• Oversight of mediations, arbitrations, and trials as appropriate
• Approve WC TPA Large Loss Reports.
• Keep a diary for all Trial Alerts.
• Management of claims-related data, intelligence, and information, including the development of tools, processes and/or reporting to improve loss outcomes and to provide insight into claim trends.
• Create a strong relationship with Captive and Program members, while providing an optimal balance of excellent customer service.
• Be open to new Lines of Business- oversight of claims.

Qualifications, Education and Experience

• Bachelor's degree required
• Minimum of 10 years of Workers Compensation Claim handling or related insurance education/experience.

Knowledge, Skills, and Abilities

• Must possess high level skills and extensive claims technical knowledge in Workers Compensation.
• Litigation experience in multiple jurisdictions of Workers Compensation.
• Must possess expert analytical, decision making, negotiation, problem-solving, project management, organizational, and teamwork skills.
• Must demonstrate superior written and oral communication skills and the ability to communicate with all levels of the organization
• Demonstrated strategic thinking capabilities
• Demonstrated proficiency with computer software including Microsoft Office suite and other Claims tracking tools.

Compensation & Benefits

The applicable base salary for this opportunity is $110,000 - $125,000.  The base pay offered will be determined by factors such as experience, skills, training, location, certifications, education, and any applicable minimum wage requirements.  In addition to the base salary, this opportunity may be eligible for performance-based incentives.

We are excited to offer a competitive total rewards package which includes health and welfare benefits, tuition and professional certification assistance, 401k savings, elective participation in the Employee Stock Purchase Program, paid time off, paid holidays, and child bonding leave, as well as other employee assistance programs.

#LI-Remote