Contestable Life Claims Manager

This is a fully remote position, open to applicants in Texas.

📋 Description

• Supervise a team of AIL Life claims associates and manage daily operations to ensure the achievement of performance and productivity standards.

• Comprehend, interpret, and communicate the contractual language in Life and Accident policies effectively.

• Provide expertise and leadership support to the team in resolving complex claim issues.

• Assess daily workflow in the Onbase platform and balance claims as needed to ensure an even distribution of work.

• Review high-cost claims and claims exceeding the authority level of individual examiners for accuracy and compliance adherence.

• Ensure each associate has the necessary tools, knowledge, and resources to succeed in their role while identifying training gaps and opportunities for retraining.

• Provide ongoing feedback to associates and counsel them on matters related to performance, attendance, and/or conduct.

• Ensure Mainframe and Onbase systems function properly and collaborate with IT to resolve system issues.

• Utilize effective written and oral communication to respond professionally and urgently to escalated claim issues received via mail, fax, or email.

• Communicate proactively with management regarding issues such as staffing, work volume fluctuations, emergency situations, etc.

• Identify opportunities for process improvements and utilize logic and reasoning to assess the strengths and weaknesses of alternative resolutions.

• Conceptualize innovative technical solutions that lead to efficiencies within the unit.

• Build and maintain strong relationships with cross-functional partners in Policy Services, Customer Service, Agency Offices, and Legal to achieve organizational goals.

• Foster a positive, high-performing team environment by exemplifying cultural expectations of accountability, continuous improvement, collaboration, and creativity.

• Motivate team members and provide developmental direction while nurturing continuous growth.

• Support culture and employee engagement initiatives and promote employee development.

• Delegate additional responsibilities and stretch assignments to high-potential examiners to prepare them for successful advancement within the organization.

• Conduct off-cycle quality review claim audits to ensure proper coding, documentation, and compliance with regulatory standards.

• Maintain and monitor a diary of questionable, sensitive, or potentially fraudulent claims.

• Collaborate with management and Human Resources to create action plans for underperforming associates and ensure adherence to progressive disciplinary guidelines.

• Write value-based performance appraisals and conduct effective performance discussions with colleagues.

• Support organizational training initiatives and ensure staff is updated on mandatory, role-appropriate training.

• Complete monthly and ad-hoc reports with data interpretation to identify trends and issues to assist management in strategic decision-making.

• Develop contingency plans to achieve objectives during challenging circumstances (e.g., staffing shortages, high work volumes, system implementations, etc.).

• Present complex information effectively to key stakeholders to influence the acceptance of innovative suggestions.

• Lead and collaborate on claims and other business projects as necessary, alongside daily responsibilities.

• Partner with management to retain staff and build bench strength within the organization to meet overall turnover goals.

• Interview, hire, and mentor new claims associates.

• Perform other duties as assigned, with some travel required.

⛳️ Requirements

• A Bachelor's degree from a four-year college or university is preferred; or 5–7 years of relevant experience and/or training; or an equivalent combination of education and experience.

• A minimum of 3 years of experience handling claims.

• Experience in interpreting the contractual language in Life and Accident policies.

• Supervisory experience is a plus.

• High technical aptitude and the ability to quickly learn new systems.

• Strong problem-solving skills with advanced analytical and interpretive abilities, using a mix of analysis, experience, and judgment to develop viable solutions.

• Excellent oral, written, and presentation skills, with the ability to convey complex ideas to upper management in a professional manner.

• Strong proficiency in 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 fulfilling obligations.

• Ability to manage competing priorities and adapt plans, goals, and actions to meet changing situations while delivering results under tight deadlines.

🏝️ Benefits

• Competitive compensation designed to reflect your expertise and contributions.

• Comprehensive health, dental, and vision insurance plans because your well-being is essential to your performance.

• Robust life insurance benefits and retirement plans, including a company-matched 401k plan.

• Paid holidays and time off to support a healthy work-life balance.

• Parental leave to assist employees in welcoming new additions to their families.

• Subsidized all-in-one subscriptions to support your fitness, mindfulness, nutrition, and sleep goals.

• Company-paid counseling for support with mental health, stress management, and work-life balance.

• Continued education reimbursement eligibility and company-funded FLMI and ICA courses to advance your career.

• Discounted Texas Rangers tickets for a memorable visit to Globe Life Field.