Complex Claims Director Job at Berkshire Hathaway Specialty Insurance (New York, NY)

Director, Complex Insurance Litigation & Strategy

Insurance is a critical part of Uber’s business, and we are constantly innovatin...

Location

United States , New York; San Francisco; Chicago

Salary:

266000.00 - 328000.00 USD / Year

Uber

Expiration Date

Until further notice

Requirements

Minimum of 10 years of litigation experience in-house and/or at a leading law firm, with substantial experience handling complex general liability, mass tort, or other high-exposure litigation
Significant trial, mediation, and strategic case resolution experience
Membership in at least one U.S. state bar

Job Responsibility

Guide high-stakes litigation strategy across Uber’s complex general liability and mass tort portfolios, including bellwether trials, coordinated proceedings, and large-scale resolution efforts
Serve as a strategic partner to senior legal leadership by independently driving initiatives, owning outcomes, and proactively developing solutions to complex legal and business challenges
Manage and help lead complex trials nationwide
significant travel required
Negotiate and mediate sophisticated, high-impact deals in complex litigation matters
Partner cross-functionally with actuarial, finance, data science, insurance, and business teams to evaluate litigation exposure, reserving strategy, long-term financial risk, and portfolio management considerations
Analyze large-scale claims inventories to develop mediation, settlement, and trial strategies that appropriately balance legal, financial, operational, and reputational considerations
Drive strategic decision-making related to litigation risk, legal precedent, and enterprise-wide exposure management
Manage outside counsel across all phases of litigation, including pleadings, discovery, expert development, motion practice, mediation, trial, and appeal
Advise legal and business stakeholders on risk mitigation initiatives, safety and product considerations, operational processes, and emerging litigation trends affecting the mobility platform

What we offer

Eligible to participate in Uber's bonus program
may be offered an equity award & other types of comp
eligible to participate in a 401(k) plan
various benefits

Fulltime

Senior Director, Claims Technology Transformation & Delivery

Berkshire Hathaway Specialty Insurance (BHSI) has an immediate opportunity for a...

Location

United States , Boston

Salary:

155000.00 - 175000.00 USD / Year

Berkshire Hathaway Specialty Insurance

Expiration Date

Until further notice

Requirements

Minimum of 10 years of experience in program and people management, including leading and managing complex systems projects
overall professional experience of at least 15 years
Proven experience with enterprise technology systems, cloud platforms, and regulatory compliance
Strong leadership, communication, and stakeholder management skills
Attention to detail and the ability to multi-task while balancing diverse priorities
Adept and eager to become engaged in a wide variety of business initiatives that require an understanding of diverse business, compliance, and technical topics
Adept at rapidly responding to changes in priorities and deadlines
Experienced in leading Agile software delivery models.

Job Responsibility

Lead and deliver a portfolio of high impact, strategically aligned initiatives across Claims technology to drive business transformation and operational efficiency
Ensure successful execution of core platform upgrade (Claims 2.0) program by aligning cross-functional collaboration with Underwriting, EDW, Security, and Infrastructure teams, ensuring timely delivery and business continuity
Lead planning, execution, and delivery of AI‑enabled Claims Automation and a greenfield Small Commercial Claims platform as part of the Claims Technology portfolio
Establish and maintain high standards for delivery excellence, risk mitigation, and stakeholder engagement to meet defined business goals
Enhance transparency and compliance by evolving governance frameworks and documentation practices
Lead and mentor a high-performing team of project managers, fostering a culture of accountability, innovation and continuous improvement to support evolving business needs
Resolve cross-functional challenges by driving clarity in scope, stakeholder alignment, and facilitating timely issue resolution to maintain project momentum
Provide executive-level visibility into program health through concise, data-driven reporting on status, risks, and interdependencies to support strategic decision-making
Embed a continuous improvement mindset through structured post-implementation reviews and feedback loops to drive operational excellence and future readiness.

What we offer

Comprehensive Health, Dental and Vision benefits
Disability Insurance (both short-term and long-term)
Life Insurance (for you and your family)
Accidental Death & Dismemberment Insurance (for you and your family)
Flexible Spending Accounts
Health Reimbursement Account
Employee Assistance Program
Retirement Savings 401(k) Plan with Company Match
Generous holiday and Paid Time Off
Tuition Reimbursement

Fulltime

Fraud & Claims Operations Director

Wells Fargo is seeking a Fraud & Claims Operations Director. We believe in the p...

Location

Philippines , Taguig City

Salary:

Not provided

Wells Fargo

Expiration Date

June 29, 2026

Requirements

10+ years of fraud claim investigations or policy violations, risk management, or compliance experience, or equivalent experience demonstrated through one or a combination of the following: work experience, training, military experience, education
6+ years management experience

Job Responsibility

Provide vision and set direction for execution and management of a risk based fraud and claims program across the enterprise with significant risk and complex regulatory environments in order to achieve long term strategic objectives that impact the organization and management across functions
Collaborate with cross channel business leaders, as well as legal, audit, and multiple US or non US regulators to develop highly complex strategies and goals
Provide thought leadership to develop and implement strategic solutions to highly complex and potentially enterprise wide business risks or challenges
Lead a team of experienced business leaders and develop risk policies, procedures, and controls for fraud and claims business area in order to achieve business objectives
Collaborate with and influence cross channel business leaders, external community members, including regulators or auditors, law enforcement, elected officials and trade groups
Lead and oversee fraud claims investigations and policy violation reviews, ensuring timely, accurate, and compliant case resolution
Provide day‑to‑day management and coaching to investigation or risk teams, driving consistent execution, quality standards, and employee development
Ensure adherence to enterprise policies, regulatory requirements, and internal control standards, escalating material risks and issues as appropriate
Review complex, high‑impact, or sensitive cases, applying strong risk judgment and investigative rigor
Identify trends, root causes, and control gaps

Fulltime

!

Director of Claims

Our client, a well-established client, is seeking a Disability Claims Director.

Location

United States , White Plains

Salary:

85000.00 - 95000.00 USD / Year

Solomon Page

Expiration Date

Until further notice

Requirements

Extensive experience in disability claims or insurance claims operations
Strong knowledge of disability insurance policies, medical documentation, and regulatory requirements
Ability to interpret complex claim and contract information to make accurate determinations
Excellent communication and customer service skills with a strong attention to detail
Experience working with claims systems and managing multiple complex cases
Bachelor’s degree preferred or equivalent experience
Leadership experience in claims operations strongly preferred

Job Responsibility

Oversee the end-to-end disability claims process, ensuring accurate, timely, and compliant claim adjudication
Review medical records, policy provisions, and financial documentation to determine eligibility and benefit entitlement
Coordinate with providers and employers to gather necessary information
Communicate with claimants regarding claim status and decisions in a professional and empathetic manner
Ensure compliance with contractual, regulatory, and internal policy requirements
Identify potential fraud indicators and escalate appropriately
Resolve complex claim issues and support appeals as needed
Drive process improvements and support operational efficiency within claims operations
Provide guidance and oversight to claims staff to ensure quality and consistency

Fulltime

Deputy Director of Construction Claims

The Honolulu Authority for Rapid Transportation (HART) is seeking a Deputy Direc...

Location

United States , Honolulu

Salary:

109700.00 - 175000.00 USD / Year

Honolulu

Expiration Date

Until further notice

Requirements

Hold a Bachelor's degree and a Juris Doctor (JD) degree from an accredited college or university
Possess at least 10 years of experience in litigation, contract administration, or construction claims, including experience with procurement, contract law, and complex state and federal court proceedings
Have proven ability to supervise staff effectively
Demonstrate strong skills in contract drafting, negotiation, and dispute resolution
Candidates must meet the health and physical condition standards necessary to perform the essential duties of this position effectively

Job Responsibility

Advise HART senior management on procurement protests, construction claims, utility agreements, third-party agreements, and insurance risk management
Participate in top-level management meetings to develop strategies and goals
Develop, review, and update policies and procedures related to construction claims and third-party agreements
Oversee and coordinate the overall Construction Claims Program, ensuring timely resolution of disputes
Utilize knowledge of Hawaii's Public Procurement Code to analyze and draft responses to bid protests and assist in preparing briefs for hearings at the Department of Commerce and Consumer Affairs
Collaborate with HART departments to identify escalating issues and disputed change orders, providing advice to prevent or support future claims
Perform cost and schedule analyses for mediation or court proceedings, working with experts on technical issues such as delays and economic damages
Manage interactions with insurance companies, requiring knowledge of surety policies, and coordinate with legal counsel on claims proceedings including depositions, motions, and document reviews
Prepare for mediation, dispute resolution boards, and court proceedings by drafting high-level documents and strategies
Conduct forensic reviews of project documentation for elevated claims and ensure compliance with Federal Transit Administration requirements

What we offer

Medical, prescription drug, vision, dental, and life insurance plans
Generous vacation and sick leave, earning up to 21 days per year
13 paid holidays annually (14 days during election year)
Retirement plan contributions through the Employees' Retirement System (ERS)
Deferred compensation options to invest pre-tax income for retirement
Flexible spending accounts for health and dependent care expenses
Pre-tax transportation benefits, including TheBus and vanpool options
Access to confidential counseling services through the Employee Assistance Program (EAP)
Additional perks include training opportunities and employer-funded Holo Card for eligible employees to use on public transit
Eligibility for the public Service Loan Forgiveness (PSLF) program, supporting employees dedicated to public service

Fulltime

Patient Financial Specialist Senior

The associate is responsible for the duties and services that are of a support n...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

HS Diploma or equivalent years of experience required
3-5 years of experience preferred
Experience calculating expected reimbursement according to payer regulations and/or contracts required
Experience with Commercial, Medicare, and Medicaid reimbursement
Medicare, Medicaid, VA, Tricare billing and collections processes and regulations preferred
College education, previous Insurance Company claims experience and/or health care billing trade school education may be considered in lieu of formal hospital experience
Prefer hands-on experience with Medicare Remote (FISS) – DDE
Must have in-depth knowledge and ability to maneuver efficiently through Patient Accounting Systems, Document Imaging, Databases, etc.
Must have understanding of Medicare and Commercial contract language
Must have good technical aptitude working with a variety of MS Office products (Word, Excel, PowerPoint, Outlook) and/or ability to learn and develop more advance skills with the various applications

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Performs Revenue Cycle functions in a manner that meets or exceeds CHRISTUS Health key performance metrics
Ensures PFS departmental quality and productivity standards are met
Functions as a subject matter expert in support of other PFS team members and other departments/facilities within the CHRISTUS Health network
Demonstrates a good understanding and has the ability to interact with the payer to verify coverage, submit claims, and follow up on appeals, underpayments, short pays or payment disputes for resolution
Investigate and resolve complex payment denials inclusive of correcting errors and supplying additional required information to facilitate collection of reimbursement / additional reimbursement
Ability to analyze, recognize, and resolve issues utilizing strategic thinking
Work with a variety of payers
Adapt to process and procedure evaluations and improvements, support continuous change, and willingly manage special projects in addition to normal workload and other duties as assigned
Responsible for professional and effective written and verbal communication with both internal and external customers

Fulltime

New

Director, Predictive Analytics and AI

Join Takeda as a Director, Predictive Analytics and AI out of our Cambridge, MA ...

Location

United States , Cambridge

Salary:

177000.00 - 278080.00 USD / Year

BioLife Plasma Services

Expiration Date

Until further notice

Requirements

Master’s or Ph.D. in Computer Science, Data Science, Statistics, Engineering, Economics or a related field required
10+ years of hands-on experience in AI/ML modeling, with at least 5 years in pharmaceutical commercial analytics required
Prior people management experience required
Strong technical expertise in machine learning, NLP, and recommendation systems
Experience with pharma data (e.g., IQVIA, Veeva, SP & claims) and strong understanding of compliance and privacy considerations
Proficiency in Artificial Intelligence, with demonstrated expertise in establishing GenAI (Generative AI) and Agentic AI methodologies and solutions
Proficient in Data Science tools and languages such as Python, R, SQL, Databricks, and is familiar with cloud platforms (AWS, Azure, GCP)
Expert in delivering persuasive presentations, conveying complex advanced Data Science driven insights to non-technical audience, and mentoring others in presentation skills
Excellent communication and collaboration skills, with the ability to work effectively in cross-functional teams
Strong project management skills, with the ability to manage multiple projects simultaneously

Job Responsibility

Advance Data Science and AI capabilities driving the utilization of predictive models in areas including Patient finding, HCP Targeting and Prioritization, Next Best Action Engines, predictive secondary data driven Patient and predictive Customer Segmentations
Advance Predictive Analytics for US. GI, NS, PDT, and Rare Disease Franchises, including new product launches or indications
Partner with BUs, BU Analytics & Insights, Marketing and Sales Ops, Data CoEs etc.to define use cases and integrate predictive model-driven decisioning into business decisions
Strategic Leadership: Develop and execute a future-oriented data science strategy for commercialization, focusing on leveraging predictive and machine learning models to solve complex business challenges
Predictive Modeling & AI Innovation: Design and deploy predictive models—including logistic regression, ensemble methods, and other machine learning algorithms—for key applications such as trialist identification, patient segmentation, next-best-action (NBA), and HCP target prioritization. Lead the development of AI/ML algorithms to predict patient events, identify undiagnosed / misdiagnosed patients to drive targeted HCP engagements. Create scalable, reusable frameworks for AI and machine learning experimentation and deployment across multiple therapeutic areas
Cross-Functional Partnership: Collaborate as a key thought partner with cross-functional teams—including Business Units, Brand Insights & Analytics, Marketing & Sales Operations, Patient Services, and Medical Affairs—to drive business impact. Develop creative strategies to ensemble multiple third-party patient data sets, enhancing coverage and precision in patient identification and predictive segmentations
Mentor and develop talent: Cultivate a high-performing team of data scientists by promoting continuous learning and encouraging the adoption of emerging AI techniques, ensuring a culture of innovation and excellence. Promote ongoing AI skill development through hands-on training, external partnerships, and internal knowledge sharing
GenAI and Agentic AI Initiatives: Establish and lead GenAI and Agentic AI initiatives that are strategically aligned with CA&I goals. Drive the adoption and integration of advanced AI technologies to enhance analytics capabilities, automate insights generation, and support innovative commercial strategies
Innovation & Continuous Improvement: Continually evolve analytical methods, platforms, standards, and toolsets to meet current and future business needs. Lead Data Science team efforts in developing advanced analytic and AI models providing continuous insights into execution optimization, and industry developments
Strategic Consultation & Stakeholder Engagement: Act as a trusted thought partner to franchise Analytics & Insights, forecasting, and Patient Diagnosis Heads - leading data science driven discussions and translating business needs into appropriate predictive modeling strategies

What we offer

short-term and/ or long-term incentives
medical, dental, vision insurance
401(k) plan and company match
short-term and long-term disability coverage
basic life insurance
tuition reimbursement program
paid volunteer time off
company holidays
well-being benefits
up to 80 hours of sick time per calendar year

Fulltime

Director, Safety & Insurance Litigation, High Exposure

The Safety & Insurance Litigation team oversees and manages litigation and claim...

Location

United States , Chicago

Salary:

266000.00 - 295500.00 USD / Year

Uber

Expiration Date

Until further notice

Requirements

Minimum of ten years (10) years of litigation experience in-house and/or at a leading law firm, with substantial experience handling complex liability or other high-exposure litigation
J.D. and license to practice law in at least one U.S. state

Job Responsibility

Oversee a team that manages a portfolio of high severity claims and litigation in the US & Canada
Help set team vision, priorities, and provide guidance on case strategy while managing results and performance
Manage outside counsel across all phases of litigation, including pleadings, discovery, expert development, motion practice, mediation, trial, and appeal
Analyze claims inventories to develop mediation, settlement, and trial strategies that appropriately balance legal, financial, operational, and reputational considerations
Collaborate with team members for operational efficiency and process revision
Partner with Uber's other teams on insurance, risk, safety, and regulatory efforts

What we offer

Bonus program
Equity award & other types of comp
401(k) plan

Fulltime

Select Country

Complex Claims Director

Job Description

Job Responsibility

Requirements

What we offer

Looking for more opportunities?