Contestable Life Claims Manager

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🕒 Junho 8

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GlobeLife

SiteLinkedInTodas as Vagas

1 - 10 funcionários

Fundada em 2020

📚 Educação

🔬 Ciência

Education • Science

GlobeLife é uma rede acadêmica colaborativa criada pela Universidade de Uppsala e pelo Instituto Karolinska para fortalecer a pesquisa e a educação em saúde global. Ela promove a colaboração multidisciplinar, organiza seminários e eventos, compartilha gravações e notícias, e aproveita a expertise das duas universidades para apoiar pesquisas, treinamentos e progresso em direção aos Objetivos de Desenvolvimento Sustentável.

Descrição

• Supervise team of AIL Life claims associates and oversee daily operations to ensure achievement of performance/productivity standards. • Understand, interpret, and effectively communicate contractual language in Life and Accident policies. • Provide expertise and leadership support to team in resolving complex claim issues. • Evaluate daily workflow in Onbase platform and load balance claims as needed to ensure even distribution of work. • Review high cost claims and claims over the authority level of individual examiners for accuracy and compliance adherence. • Ensure each associate is equipped with the tools, knowledge and resources to be successful in their role while also recognizing training gaps and opportunities for retraining. • Provide constant feedback to associates and counsel on matters of performance, attendance, and/or conduct. • Ensure Mainframe & Onbase systems are functioning properly and partner with IT to address system issues. • Utilize effective written and oral communication to respond professionally and with a sense of urgency to escalated claim issues received via mail, fax, or email. • Proactively communicate with management regarding problems such as staffing, high/low work volume, emergency situations, etc. • Identify process improvement opportunities and use logic and reasoning to compare strengths/weaknesses of alternative resolutions. • Conceptualize innovative technical solutions that translate into efficiencies within the unit. • Develop and maintain strong relationships with cross functional partners in Policy Services, Customer Service, Agency Offices, and Legal to accomplish organizational goals. • Cultivate a positive, high-performing team by modeling cultural expectations of accountability, continuous improvement, collaboration, and creativity. • Motivate and provide development direction to team members while fostering an environment of continuous growth. • Support culture and employee engagement activities and promote employee development. • Delegate additional responsibilities and stretch assignments to high potential examiners to position them for successful advancement within the organization. • Perform off-cycle quality review claim audits to ensure proper coding, documentation, and compliance with regulatory standards. • Maintain and monitor diary of questionable, sensitive, or possible fraudulent claims. • Collaborate with manager and Human Resources to develop action plans for underperforming associates and ensure adherence to progressive disciplinary guidelines. • Write value-based performance appraisals and conduct effective colleague performance discussions. • Support organizational training initiatives and ensure staff is updated on mandatory role-appropriate training. • Complete monthly/adhoc reports with data interpretation to identify trends and issues to facilitate management in strategic decision making. • Develop contingency plans to meet objectives during challenging circumstances (i.e. staffing shortages, high work volumes, system implementation, etc.). • Effectively present complex information to key stakeholders to influence acceptance of innovative suggestions. • Lead and partner on claims and other business projects as needed, concurrently with daily responsibilities. • Partner with manager to retain staff and build bench strength within the organization to achieve overall turnover goals. • Interview, hire, and mentor new claims associates.

🎯 Requisitos

• Bachelor's degree from a four-year college or university preferred; or 5–7 years of related experience and/or training; or an equivalent combination of education and experience. • At least 3 years of experience handling claims. • Experience interpreting contractual language in Life and Accident policies. • Supervisory experience, a plus. • High technical aptitude and ability to learn new systems quickly. • Strong problem-solving skills with advanced analytical and interpretive abilities, using a combination of analysis, experience, and judgment to develop feasible solutions. • Excellent oral, written, and presentation skills, including the ability to communicate complex ideas to upper management in a professional manner. • Strong knowledge of Microsoft Office Suite (Outlook, Excel, PowerPoint, Access, etc.). • Ability to work independently, make autonomous decisions with minimal supervision, and take ownership of tasks, projects, and relationships while following through on obligations. • Ability to manage competing priorities and adjust plans, goals, and actions to meet changing situations while delivering results under rigorous deadlines.

🏖️ Benefícios

• Competitive compensation designed to reflect your expertise and contribution. • Comprehensive health, dental, and vision insurance plans because your well-being is fundamental to your performance. • Robust life insurance benefits and retirement plans, including company-matched 401k plan. • Paid holidays and time off to support a healthy work-life balance. • Parental leave to help our employees welcome their new additions. • Subsidized all-in-one subscriptions to support your fitness, mindfulness, nutrition, and sleep goals. • Company-paid counseling for assistance with mental health, stress management, and work-life balance. • Continued education reimbursement eligibility and company-paid FLMI and ICA courses to grow your career. • Discounted Texas Rangers tickets for a proud visit to Globe Life Field.