Careers

Director of Claims

Position Summary

The Director of Claims and Compliance leads the overall operation of the Claims department and reports to the President and CEO. This role supervises claim managers, claim counsel, claim investigators, and claim specialists in evaluating liability, damages, exposure, reserves, defense strategy, and claim resolution.

The Director provides claims leadership, supports the delivery of value-added legal services to insureds, and coordinates with Underwriting and Risk Management to identify loss trends, assess risk exposures, and develop responses that improve loss performance and patient safety. The role also represents Claims as a member of the team leadership group and advances department initiatives and customer-focused services.

What You Will Do

• Lead the day-to-day operation of the Claims department and provide direction, support, and performance oversight to claims personnel.
• Review coverage and reserving recommendations prepared by claims staff and help ensure that case reserves are appropriate, timely, and well supported.
• Supervise claim managers, claim counsel, claim investigators, and claim specialists in the evaluation and resolution of claims.
• Analyze liability, damages, exposure, defense strategy, settlement opportunities, and trial considerations; make recommendations to executive management regarding significant matters and settlement authority.
• Monitor claims for timely completion of case summaries, reserve changes, reinsurance reporting, and other required claim documentation.
• Select investigating companies and defense counsel, establish rates, and monitor the quality, efficiency, and performance of outside service providers.
• Lead claim committee meetings and provide clear, practical direction on claim handling, legal strategy, and resolution planning.
• Supervise value-added legal and claims services provided to insureds, including services designed to address identified customer needs.
• Implement and complete strategic initiatives assigned to the Claims department and recommend improvements to processes, services, and results.
• Represent the Claims department on the team leadership group; collaborate with executive management, Underwriting, Risk Management, Finance, and other business partners; and identify customer needs and service opportunities through feedback.

What You Bring

• Four-year undergraduate degree and Juris Doctor degree from an accredited law school.
• Active license to practice law in Missouri, in good standing.
• At least 10 years of experience in civil litigation, with an emphasis on medical malpractice claims.
• Strong knowledge of claim evaluation, coverage, reserving, defense strategy, settlement analysis, and litigation management.
• Demonstrated ability to lead claims professionals, exercise sound judgment, communicate recommendations to executive management, and manage competing priorities with accuracy and discretion.
• Professional written and verbal communication skills, collaborative leadership, integrity, confidentiality, and a service-oriented approach to insureds and business partners.

Work Environment

This is a full-time position based in Jefferson City, Missouri. The role requires regular use of a computer and telephone, sustained attention to detailed information, and the ability to work collaboratively with claims, legal, underwriting, risk management, and executive leadership teams. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.

Additional Information

This posting summarizes the general nature and level of work expected for the position. It is not an exhaustive list of responsibilities, duties, or qualifications, and responsibilities may change based on business needs. Employment is subject to applicable company policies and legal requirements.

We are an equal opportunity employer and consider qualified applicants without regard to race, color, religion, sex, pregnancy, national origin, age, disability, genetic information, veteran status, or any other status protected by applicable law.

Please email your resume to:

Leslie Jeffries, Director of Human Resources

ljeffries@hsg-group.com

Claim Counsel

Position Summary

Claims Counsel independently manages an assigned inventory of medical professional liability and related claims from initial notice through final resolution. Applying legal and claims judgment within delegated authority, this role analyzes coverage, liability, causation, damages, litigation strategy, reserves, and resolution opportunities while providing responsive service to insured healthcare professionals and organizations.

Claims Counsel serves as an internal legal and claims resource, directs defense counsel and other service providers, and works closely with Claims leadership, Underwriting, Risk Management, Finance, Claims Administration, and other business partners. The role requires proactive file ownership, practical legal analysis, accurate documentation, sound financial stewardship, and clear communication.

What You Will Do

• Manage an assigned inventory of claims and incidents from initial receipt through final disposition, taking timely action at each diary interval and maintaining complete, accurate, and contemporaneous electronic file documentation.
• Handle matters in accordance with applicable insurance policies, legal and regulatory requirements, company procedures, delegated authority, and current claims guidelines.
• Review notices of claims and incidents; analyze policy language and coverage; identify potential denials, reservations of rights, material coverage questions, conflicts, and other significant issues; and elevate matters requiring additional approval or specialized review.
• Evaluate liability, causation, damages, venue, defenses, co-defendant responsibility, potential exposure, and resolution strategy through factual, legal, medical, and financial analysis.
• Establish or recommend timely indemnity and expense reserves within delegated authority, document the supporting rationale, and update reserves when material information changes the expected ultimate loss or allocated expense.
• Conduct regular reviews of every assigned open file to assess reserve adequacy, investigation or litigation status, current strategy, and the actions needed before the next review.
• Select, retain, assign, and direct qualified investigators, defense counsel, consultants, and experts in accordance with company procedures; provide clear assignments and monitor strategy, performance, reporting, budgets, fees, and invoices.
• Review and analyze pleadings, discovery, medical records, expert opinions, investigation reports, evaluations, legal research, and litigation budgets; provide strategic direction and follow up on outstanding work.
• Prepare timely claim reports, legal and claim analyses, claim summaries, reserve and settlement recommendations, management reports, and other required documentation.
• Provide timely, candid, and appropriately detailed communications and notices to insureds, management, reinsurers, regulators, Finance, and other stakeholders while preserving privilege, confidentiality, and protected information as required.
• Serve as a primary claims and legal contact for insureds; explain claim status and strategy; assist with pre-suit matters, subpoenas, depositions, discovery, and early-intervention opportunities; and respond promptly and professionally to questions and concerns.
• Evaluate settlement opportunities, participate in negotiations, and resolve matters within delegated authority; prepare well-supported requests for additional reserve or settlement authority.
• Promptly escalate policy-limit, excess, time-sensitive, reputational, conflict-sensitive, or otherwise significant demands and issues in accordance with company procedures.
• Attend mediations, settlement conferences, significant depositions, hearings, and trials when appropriate, including travel or work outside normal business hours when claim needs require.
• Monitor indemnity and expense payments and confirm that authority, supporting documentation, releases, closing materials, reinsurance communications, and system entries are complete before a file is closed.
• Conduct periodic claim reviews with insureds and provide appropriate healthcare-law, medical-legal, claims, risk-management, and educational support, including presentations and training programs.
• Develop and maintain subject-matter expertise in an assigned legal, claims, or operational area, such as HIPAA and the handling of protected health information, and help maintain current guidance, processes, and training for that area.
• Participate in claim committee and departmental meetings; identify claim trends, legal developments, and emerging risks; collaborate with business partners; recommend process and service improvements; and support training and mentoring of less experienced claims personnel.

What You Bring

• Bachelor’s degree and Juris Doctor degree from an accredited law school.
• Active license to practice law in Missouri, with ongoing good standing and compliance with applicable continuing legal education requirements.
• Relevant experience in medical professional liability, healthcare litigation, complex casualty claims, insurance coverage, or comparable claim management; direct medical malpractice experience is strongly preferred.
• Working knowledge of civil litigation, medical malpractice and general liability principles, claim investigation, coverage analysis, reserving, negotiation, litigation budgeting, and settlement evaluation.
• Ability to analyze complex legal, medical, factual, and financial information; exercise independent legal and claims judgment within delegated authority; and provide practical, business-oriented advice.
• Demonstrated ability to manage a substantial caseload, competing deadlines, and detailed documentation while maintaining timely follow-through.
• Clear, professional written and verbal communication with insureds, counsel, leaders, regulators, vendors, and other stakeholders.
• High standards of integrity, confidentiality, professionalism, organization, collaboration, customer service, and financial stewardship, with the ability and willingness to travel or occasionally work outside normal business hours.

Preferred Qualifications

• Experience managing medical malpractice or professional liability claims involving physicians, hospitals, or other healthcare organizations.
• Experience analyzing insurance coverage, drafting coverage communications, directing defense counsel, and evaluating significant or complex litigation.
• Familiarity with reinsurance reporting, healthcare privacy requirements, and regulated claim environments.
• Professional certifications such as RPLU, CPHRM, CPCU, AIC, or comparable credentials.

Work Environment

This is a full-time hybrid position based in Jefferson City, Missouri, subject to business needs and company policy. The role requires regular use of a computer and telephone, sustained attention to detailed information, and periodic travel for claim-related activities. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.

Additional Information

This description summarizes the general nature and level of work expected for the position. It is not an exhaustive list of responsibilities, duties, or qualifications, and responsibilities may change based on business needs. Employment is subject to applicable company policies and legal requirements.

We are an equal opportunity employer and consider qualified applicants without regard to race, color, religion, sex, pregnancy, national origin, age, disability, genetic information, veteran status, or any other status protected by applicable law.

Please email your resume to:

Leslie Jeffries, Director of Human Resources

ljeffries@hsg-group.com