Contestable Life Claims Manager

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GlobeLife

WebsiteLinkedInAlle Stellen

1 - 10 Mitarbeiter

Gegründet 2020

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🔬 Wissenschaft

Education • Science

GlobeLife ist ein kollaboratives akademisches Netzwerk, das von der Universität Uppsala und dem Karolinska Institutet gegründet wurde, um Forschung und Lehre im Bereich globale Gesundheit zu stärken. Es fördert die interdisziplinäre Zusammenarbeit, organisiert Seminare und Veranstaltungen, teilt Aufzeichnungen und Nachrichten und nutzt die Expertise beider Universitäten, um Forschung, Ausbildung und Fortschritte in Richtung der Ziele für nachhaltige Entwicklung zu unterstützen.

Beschreibung

• 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.

🎯 Anforderungen

• 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.

🏖️ Vorteile

• 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.