Manager, Life & Complex Claims

Job not on LinkedIn

🔥 2 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

F&G

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1959

🛡️ Insurance

💸 Finance

🏢 Enterprise

Insurance • Finance • Enterprise

F&G is a company that provides a portal for sales agents to manage their accounts and access resources. The SalesLink agent portal requires users to log in with their agent ID and password, offering features for password management and security protocols. F&G seems to focus on providing services and support for sales agents, possibly in the insurance or financial industry, as suggested by the email domain '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

🎯 Requirements

• 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

🏖️ Benefits

• 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