Manager, Life & Complex Claims

đź•’ vor 19 Tagen

🇺🇸 Vereinigte Staaten – Remote

⏰ Vollzeit

🟡 Mittelstufe

đźź  Senior

đź‘” Manager

🗣️🇺🇸🇬🇧 Englisch erforderlich

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Logo of F&G

F&G

501 - 1000 Mitarbeiter

GegrĂĽndet 1959

🛡️ Versicherung

đź’¸ Finanzen

🏢 Unternehmen

Insurance • Finance • Enterprise

F&G ist ein Unternehmen, das ein Portal für Vertriebsmitarbeiter anbietet, um deren Konten zu verwalten und Ressourcen zu nutzen. Das Vertriebsportal SalesLink erfordert, dass sich Benutzer mit ihrer Vertriebs-ID und ihrem Passwort anmelden, und bietet Funktionen für Passwortverwaltung und Sicherheitsprotokolle. F&G scheint sich auf die Bereitstellung von Dienstleistungen und Unterstützung für Vertriebsmitarbeiter zu konzentrieren, möglicherweise in der Versicherungs- oder Finanzbranche, wie die E-Mail-Domain 'fglife. com' andeutet.

Beschreibung

• Provide secondary review and financial approval for life claims, contestable investigations, policy rescissions, and living benefit rider claims • Direct end-to-end medical investigations during the contestability period • Lead weekly Complex Claims Roundtables with Underwriting, Legal, and Compliance • Serve as the primary escalation point for complex claims, appeals, contested denials, and regulatory inquiries • Manage workflows with IME providers, FCE vendors, retrieval services, investigation partners, and reinsurers • Mentor and upskill specialized examiners in investigative techniques, medical record analysis, fraud indicators, policy provisions, and claims skills • Establish and monitor performance metrics through 1:1s, development plans, and corrective action • Manage workload allocation and queue segmentation to maintain SLA compliance and prevent aged inventory • Evaluate workflows, letters, and forms to reduce cycle times and improve customer experience • Oversee SOPs, job aids, and training documentation for life, living benefit, and complex claim adjudication • Use claims data and Business Intelligence dashboards to identify delays, quality trends, and fraud patterns • Oversee life and complex Claims functions and ensure compliance with state and industry regulations • Oversee quality review, claims governance, authority levels, escalation protocols, and risk mitigation • Manage performance, develop talent, and support team engagement and effectiveness

🎯 Anforderungen

• 5+ years of relevant experience • 5+ years of progressive claims adjudication experience in Life, Disability, Contestable, and/or Living Benefit Riders Claims • 2+ years of direct people leadership or proven technical supervisory/mentorship experience within a specialized claims environment • Bachelor's degree preferred or equivalent professional experience • Combination of education and experience considered in lieu of degree • Professional designations through LOMA (e.g., FLMI, ALMI) or the International Claim Association (ICA) (e.g., FLHC) preferred • Experience in Lean, Six Sigma, or continuous process improvement methodologies preferred • Strong life and/or disability claim expertise, with in-depth knowledge of contestable and accelerated benefit claims • Experience with state contestability statutes, unfair claims settlement practices regulations, HIPAA standards, and policy rider language • Ability to synthesize medical records, legal documents, trust agreements, and historical application data • Current knowledge of life and annuity regulations, state claims handling requirements, unclaimed property laws, and compliance obligations • Regular and punctual attendance • Ability to travel up to 10% of the time

🏖️ Vorteile

• Ability for in-office, hybrid and remote work arrangements, decided with the leader during the hiring process • Reasonable accommodations for applicants and candidates with disabilities • Employee-centric flexible/hybrid work environment

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