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Direct Claims Jobs in Kentucky (NOW HIRING)

$170 - $230/hr

Direct claims activity of our Third-Party Administrators (TPAs), ensuring compliance with TPA Agreements and authority granted, delivery of high-quality claim service, including investigation ...

New

Claims Director

Newport, KY · On-site

$125 - $150/hr

Claims Reports To: Chief Legal Officer Position Summary The Claims Director leads the Claims Department and oversees the investigation, evaluation, negotiation, and resolution of cargo, property ...

The Claims Director leads the Claims Department and oversees the investigation, evaluation, negotiation, and resolution of cargo, property damage, and related claims. This role provides strategic ...

The Claims Director leads the Claims Department and oversees the investigation, evaluation, negotiation, and resolution of cargo, property damage, and related claims. This role provides strategic ...

Director, Senior Care Claims

Lexington, KY · On-site +1

$125K - $160K/yr

Engage in projects or other responsibilities/tasks outside of direct claim handling. Actively self-educate as to line of business, industry and insurance trends including exposures, claims, legal ...

Director, Senior Care Claims

Lexington, KY · On-site +1

$125K - $160K/yr

... direct claim handling. • Actively self-educate as to line of business, industry and insurance trends including exposures, claims, legal, legislative, healthcare, current events, self-improvement ...

Answer inbound calls and direct customers to the appropriate resources. * Deliver exceptional ... Update claims documentation and maintain accurate records. * Prepare, process, and distribute ...

Answer inbound calls and direct customers to the appropriate resources. * Deliver exceptional ... Update claims documentation and maintain accurate records. * Prepare, process, and distribute ...

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Direct Claims information

What is a direct claim?

Direct claims refer to insurance claims that are filed directly by the policyholder with their own insurance company, rather than going through a third party or the at-fault party's insurer. This process is common in situations like auto accidents, where the policyholder seeks compensation for damages or losses under their own policy. Direct claims help streamline the process, reduce delays, and ensure the policyholder receives prompt assistance and settlements. They are often associated with 'first-party' insurance coverage, such as collision, comprehensive, or health insurance claims.

What are the key skills and qualifications needed to thrive as a direct claims specialist?

To thrive as a Direct Claims Specialist, you need a solid understanding of insurance policies, claims processes, and relevant legal regulations, often supported by a degree in business, finance, or a related field. Familiarity with claims management software, customer relationship management (CRM) systems, and sometimes industry certifications like AIC or CPCU is typical. Exceptional attention to detail, problem-solving abilities, and strong communication skills set top performers apart in this role. These skills and qualifications ensure claims are processed accurately and efficiently, leading to customer satisfaction and minimized risk for the insurer.

What are some common challenges faced by professionals in direct claims roles, and how can they effectively manage these challenges?

Professionals in Direct Claims often face the challenge of balancing a high volume of claims with the need for thorough investigation and timely resolution. Managing customer expectations and handling sensitive situations, such as denied claims or complex cases, can also be demanding. Effective communication, strong organizational skills, and staying updated on policy guidelines are crucial for success. Building collaborative relationships with adjusters, underwriters, and other departments helps ensure accurate and efficient claims processing.

What is the difference between Direct Claims vs Claims Adjuster?

AspectDirect ClaimsClaims Adjuster
CredentialsInsurance license, knowledge of policiesInsurance license, sometimes certifications like AIC or CPCU
Work EnvironmentCustomer service, office or remoteFieldwork, office, or remote
Employer & IndustryInsurance companies, agenciesInsurance companies, third-party administrators
Search & Comparison IntentUnderstanding direct claims handlingEvaluating claims adjustment roles

Direct Claims professionals primarily handle claims directly from policyholders, focusing on processing and resolving claims within the insurance company. Claims Adjusters evaluate, investigate, and settle claims, often working in the field or remotely. Both roles require insurance licensing, but Claims Adjusters may have additional certifications. While their work overlaps in claims processing, Direct Claims roles are more customer-facing, whereas Claims Adjusters focus on assessment and negotiation.

What cities in Kentucky are hiring for Direct Claims jobs?

Cities in Kentucky with the most Direct Claims job openings:

$170 - $230/hr

Other

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Job description

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PartnerRe is a leading, privately owned, multi-line global reinsurer with a reputation of financial stability and strength, and a commitment to rebuilding businesses and communities after risk events around the world.

Our mission is to continue to be a financially stable and predictable business partner, supporting our clients with solutions tailored to their needs, delivering superior returns to our owner, providing rewarding opportunities for our people and making a positive contribution to society. To achieve this, we live by our values of Integrity, Performance, Collaboration, Straightforward Communication and Respect and Care.

Core to The PartnerRe Experience is our global nature. No matter where you sit in the company, you are part of something bigger. Our teams represent our truly international mindset, forging connections across office locations and all levels of the organization and building a network of mutual success. The result is a day-to-day experience that will allow you to:

We are always looking for bright, proactive individuals to join our team!

PartnerRe is an equal opportunities employer.

Overall Summary:

We are a global, diversified reinsurer with a growing portfolio of E&S lines insurance products written through MGAs. Our centralized structure enables us to deliver a personalized, technically sound, and client-focused approach to the marketplace. With a multicultural workforce and a collaborative ethos, we pride ourselves on being a true global organization that values expertise, partnership, and innovation.

We are seeking a seasoned claims professional to manage a claims team supporting a growing primary insurance / MGA profit center with coverages spanning Property and Casualty (P&C), as well as Financial Lines, including Directors & Officers (D&O) and Errors & Omissions (E&O) and Transactional Liability (TL). This role offers the opportunity to manage experienced claims colleagues and MGA/TPA relationships, forecast and produce operational results, and work on complex, high-value claims in a dynamic and intellectually engaging environment.

Key Responsibilities:

  • Team Leadership: Actively manage, mentor, and participate in the work of a team of claims specialists, ensuring high standards and fostering professional development.
  • Stakeholder Collaboration: Partner effectively with internal underwriting, actuarial, and legal teams, as well as external brokers, MGAs, TPAs and clients, to ensure alignment and transparency. Communicate with all internal business partners to ensure awareness of large losses and market trends.
  • Managerial Oversight of TPAs:Direct claims activity of our Third-Party Administrators (TPAs), ensuring compliance with TPA Agreements and authority granted, delivery of high-quality claim service, including investigation,documentation, coverage review, reserving, resolution strategy, and conformance to agreed KPIs.
  • Claims Management: Lead end-to-end handling, exposure evaluation and reserving of claims across P&C and Financial Lines coverages. Thoroughly investigate and assess liability and damages, particularly on high-severity claims. Recommend and set appropriate reserves within authority. Drive technical excellence to control indemnity and expense spend through timely and appropriate reserving, and reasonable ultimate claim resolution through to closure.
  • Claims Governance: Ensure team compliance with internal claims best practices relating to file management to ensure accurate and organized internal claims documentation, data capture and coverage analysis, and compliance with regulatory claim handling expectations.
  • Coverage Analysis: Identify, analyze, and resolve coverage issues under relevant policy forms. Communicate coverage positions clearly and professionally to insureds, brokers, and MGAs.
  • Collaborate with Legal: Collaborate with legal team responsible for managing litigation and dispute resolution processes, including participation in mediations, settlement conferences and trials. Coordinate with legal to formulate and implement legal strategy and control expense spend.
  • Customer Service Excellence: Deliver responsive, thoughtful, and solution-oriented service to insureds and distribution partners throughout the claims lifecycle.
  • Travel: Attend mediations, trials, and settlement conferences as needed.

Work Experience:

  • Minimum 10 years of claims handling experience, with a strong background Property and Casualty, and preferably experience in Financial Lines, particularly E&O and D&O.
  • Minimum 5 years prior experience with MGA/TPA operational relationship management in a carrier or legal environment, including demonstrated team leadership / people management experience.
  • Demonstrated ability to work independently and exercise sound judgment.
  • Exceptional interpersonal, negotiation, and communication skills.
  • Proven ability to manage relationships with sophisticated clients and brokers.
  • Strong team orientation with a collaborative mindset.

Education:

Why Join Us?

  • Be part of a high-performing, globally integrated team.
  • Work on complex and intellectually stimulating claims.
  • Enjoy a supportive and inclusive culture that values your expertise.
  • Contribute to a company that isexpanding and innovating in the Excess & Surplus Lines insurance space.
Additional Information #LI-Hybrid:

PartnerRe provides a working environment in which diversity is valued, where all employees feel welcome, respected, and empowered to perform at their best. We invite you to learn more about D&I at PartnerRe.

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