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Complex Claims Director Jobs in Iowa (NOW HIRING)

Berkley

SIU Manager

Urbandale, IA · On-site

Oversee the intake, triage, and assignment of suspected fraudulent claims, ensuring timely and thorough investigations. * Direct the investigation of complex, high-value, or sensitive cases involving ...

Humana Inc

Lead Medical Director

Des Moines, IA · On-site

$270.80 - $378.80/hr

... health claims. The Lead Medical Director requires a solid understanding of how organization ... Identify and resolve complex clinical, technical, and operational issues that arise during case ...

New

Securian

Medical Director (Remote)

Des Moines, IA · On-site

$212K - $287K/yr

Provide decisions for UW and claims based on solid medical knowledge consistent with current ... Demonstrated ability to approach complex problems with an inquisitive mindset and a genuine desire ...

Securian

Medical Director (Remote)

Des Moines, IA · On-site

$211K - $287K/yr

Provide decisions for UW and claims based on solid medical knowledge consistent with current ... Demonstrated ability to approach complex problems with an inquisitive mindset and a genuine desire ...

HealthCheck360

Member Services Advocate

Asbury, IA · On-site

... claims processes, including direct interaction with providers or carriers. Successful candidates will be confident advocating on behalf of members in complex situations and comfortable managing ...

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Complex Claims Director information

What is the difference between Complex Claims Director vs Claims Manager?

AspectComplex Claims DirectorClaims Manager
CredentialsTypically requires a professional insurance certification (e.g., CPCU, ARM) and extensive industry experienceOften requires relevant insurance licenses and several years of claims handling experience
Work EnvironmentStrategic leadership in large insurance companies or third-party administrators, overseeing complex claimsDay-to-day claims processing and team supervision within insurance companies or agencies
Employer & Industry UsageCommonly found in large insurers, TPA firms, and corporate risk managementWidely used across insurance carriers, agencies, and claims departments

The Complex Claims Director focuses on managing and overseeing complex, high-value claims and strategic claims operations, often at a senior level. In contrast, Claims Managers handle daily claims processing, team supervision, and operational tasks. Both roles require industry-specific credentials, but the Director position emphasizes strategic oversight of complex cases.

How does a complex claims director typically collaborate with legal teams and other departments during high-stakes claims investigations?

As a Complex Claims Director, collaboration with legal teams and other departments such as underwriting, risk management, and compliance is a central part of the role. Directors often lead cross-functional meetings to share critical case updates, discuss strategies for claim resolution, and ensure all regulatory and contractual requirements are met. Effective communication and coordination are essential, as these cases may involve litigation, negotiations, and extensive documentation. Building strong relationships across departments helps streamline the process and achieve the best possible outcomes for both the client and the organization.

What are the key skills and qualifications needed to thrive as a complex claims director, and why are they important?

To thrive as a Complex Claims Director, you need deep expertise in insurance claims management, strong analytical abilities, and a relevant bachelor's degree or higher, often with industry certifications such as CPCU or AIC. Familiarity with claims management systems, regulatory compliance tools, and advanced reporting software is typically required. Exceptional leadership, negotiation, and decision-making skills help you manage teams and resolve high-stakes claims efficiently. These competencies are crucial for ensuring accurate claim resolution, minimizing risk, and maintaining client trust in complex insurance environments.

What is a complex claims director?

Complex Claims Directors are senior insurance professionals responsible for overseeing the management and resolution of intricate insurance claims, often involving large financial exposures, multiple parties, or complex legal issues. They lead a team of claims specialists, coordinate with legal counsel, and ensure that claims are handled efficiently and in compliance with company policies and regulations. Their expertise helps organizations mitigate risk and ensure fair outcomes for all parties involved.
What are popular job titles related to Complex Claims Director jobs in Iowa? For Complex Claims Director jobs in Iowa, the most frequently searched job titles are:
What job categories do people searching Complex Claims Director jobs in Iowa look for? The top searched job categories for Complex Claims Director jobs in Iowa are:
Complex Claims Director jobs near you
Infographic showing various Complex Claims Director job openings in Iowa as of August 2026, with employment types broken down into 1% As Needed, 87% Full Time, 10% Part Time, and 2% Contract. Highlights an 84% Physical, 5% Hybrid, and 11% Remote job distribution.

SIU Manager

Berkley

Urbandale, IA • On-site

Full-time

Re-posted 19 days ago

Job description

"Our Company provides a state of predictability which allows brokers and agents to act with confidence."
Founded in 1967, W. R. Berkley Corporation has grown from a small investment management firm into one of the largest commercial lines property and casualty insurers in the United States.
Along the way, we’ve been listed on the New York Stock Exchange, become a Fortune 500 Company, joined the S&P 500, and seen our gross written premiums exceed $10 billion.
Today the Berkley brand comprises more than 50 businesses worldwide and is divided into two segments:  Insurance and Reinsurance and Monoline Excess.  

The Company is an equal employment opportunity employer.


The SIU Manager is responsible for assisting with leading our anti-fraud efforts to include both commercial and personal lines of business. This role is critical in safeguarding the integrity of our claims process, mitigating financial losses, and ensuring compliance with regulatory mandates.

The SIU Manager will be responsible for overseeing a team of investigators and support specialists, managing complex and high-exposure investigations, and assisting with investigative tools to support the enterprise anti-fraud efforts. This position requires a deep understanding of commercial and personal insurance operations, investigative techniques, and regulatory frameworks.

Key Functions/Duties of Position:

Leadership & Strategy

  • Lead, mentor, and manage a team of SIU investigators and support specialists, ensuring high performance, professional development, and adherence to best practices.
  • Execute a strategic vision for fraud detection and prevention across all lines of business.
  • Establish and monitor key performance indicators (KPIs) to measure the effectiveness of the SIU program.
  • Collaborate with senior leadership to align SIU goals with broader organizational objectives.

Investigative Oversight

  • Oversee the intake, triage, and assignment of suspected fraudulent claims, ensuring timely and thorough investigations.
  • Direct the investigation of complex, high-value, or sensitive cases involving potential fraud, collusion, staged losses, or organized crime.
  • Ensure investigative activities are conducted in accordance with legal standards, company policies, and industry best practices.
  • Review and approve investigative reports, summaries, and referrals to law enforcement or regulatory bodies.

Quality Assurance & Compliance

  • Manage and implement a comprehensive quality assurance program to evaluate the accuracy, completeness, and compliance of SIU investigations.
  • Conduct regular audits of investigative files to ensure adherence to internal protocols, regulatory requirements, and industry standards.
  • Provide feedback and coaching to investigators based on audit findings to drive continuous improvement.
  • Monitor trends in investigative performance and develop targeted training or process enhancements as needed.
  • Ensure timely and accurate reporting to state fraud bureaus, the NICB, and other regulatory entities.

Compliance & Reporting

  • Ensure compliance with all applicable state and federal regulations, including mandatory fraud reporting requirements.
  • Maintain accurate and timely documentation of all investigative activities in the case management system.
  • Prepare and submit regulatory reports, internal dashboards, and executive summaries as required to SIU Leadership.
  • Serve as a primary liaison with state fraud bureaus, the National Insurance Crime Bureau (NICB), and other external agencies.

Collaboration & Training

  • Partner with claims, underwriting, legal, and risk management teams to identify fraud trends and vulnerabilities.
  • Provide training and guidance to claims staff on fraud indicators, red flags, and referral procedures.
  • Represent the company at industry conferences, fraud task forces, and professional associations.

Technology & Innovation

  • Leverage data analytics, predictive modeling, and fraud detection software to enhance investigative capabilities.
  • Evaluate and implement new tools and technologies to improve SIU efficiency and effectiveness.

Qualifications:

• Minimum of 7–10 years of experience in insurance fraud investigations, with minimum of 3 years in a supervisory or managerial role.
• Extensive knowledge of commercial and personal insurance products and claims processes.
• Completion of one or more of the following designations: Fraud Claims Law Specialist (FCLS), Certified Insurance Fraud Investigator (CIFI), Certified Fraud Examiner (CFE), Chartered Property Casualty Underwriter (CPCU), Associate in Claims (AIC).

Education Requirement


• Bachelor’s degree in Criminal Justice, Insurance, Business Administration, or a related field.


Location and Travel:
Primary location Urbandale, IA.
Additional locations: High Point, NC; Irving, TX; Florida; Atlanta, GA; Glen Allen, VA; Chesterfield, MO; Scottsdale, AZ; Pennsylvania.
Travel: Occasional travel is required (up to 20%).
Sponsorship not Offered for this Role

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