Manager, Life & Complex Claims

🕒 il y a 19 jours

🇺🇸 États-Unis – Télétravail

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

👔 Manager

👻 Score fantôme 10%

Ce que ça veut dire : la probabilité que cette offre reste ouverte sans recrutement actif.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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F&G

Site WebLinkedInTous les Emplois

501 - 1000 employés

Fondée en 1959

🛡️ Assurance

💸 Finance

🏢 Entreprise

Insurance • Finance • Enterprise

F&G est une entreprise qui fournit un portail permettant aux agents commerciaux de gérer leurs comptes et d'accéder à des ressources. Le portail SalesLink pour agents requiert une connexion avec l'identifiant et le mot de passe de l'agent, offrant des fonctionnalités pour la gestion des mots de passe et des protocoles de sécurité. F&G semble se concentrer sur la fourniture de services et de soutien aux agents commerciaux, possiblement dans le secteur de l'assurance ou financier, comme le suggère le domaine de courriel 'fglife. com'.

Description

• 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

🎯 Exigences

• 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

🏖️ Avantages

• 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