Contestable Life Claims Manager

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

📋 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 effectively convey the contractual language found in Life and Accident policies.

• Offer expertise and leadership support to the team in resolving intricate claim issues.

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

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

• Ensure that each associate has the tools, knowledge, and resources needed to succeed in their roles, while also identifying training gaps and opportunities for retraining.

• Provide ongoing feedback to associates and counsel them on performance, attendance, and conduct issues.

• Ensure the functionality of Mainframe & Onbase systems and collaborate with IT to resolve system issues.

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

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

• Identify opportunities for process improvements and apply 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.

• Inspire and guide team members while cultivating an atmosphere of ongoing growth.

• Promote culture and employee engagement activities, as well as support 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 adherence to regulatory standards.

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

• Collaborate with the manager and Human Resources to create action plans for underperforming associates, ensuring compliance with progressive disciplinary guidelines.

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

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

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

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

• Effectively present complex information to key stakeholders to gain acceptance of innovative suggestions.

• Lead and collaborate on claims and other business projects as needed while managing daily responsibilities.

• Work with the manager to retain staff and strengthen the organization to meet overall turnover goals.

• Interview, hire, and mentor new claims associates.

⛳️ Requirements

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

• A minimum of 3 years of experience in handling claims.

• Experience in interpreting 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 capabilities, utilizing a blend of analysis, experience, and judgment to develop viable solutions.

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

• Proficient 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 commitments.

• Capability to manage competing priorities and adjust plans, goals, and actions to adapt to changing situations while delivering results under strict deadlines.

🏝️ Benefits

• Competitive compensation that reflects your expertise and contribution.

• Comprehensive health, dental, and vision insurance plans, as 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 promote a healthy work-life balance.

• Parental leave to assist our employees in welcoming new family members.

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

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

• Eligibility for continued education reimbursement and company-paid FLMI and ICA courses to advance your career.

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