Paid Leave Claim Manager – Employee Benefits

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

📋 Description

• Oversee and provide guidance to claims examiners during the adjudication process.

• Plan, assign, and manage the workloads of claim examiners.

• Evaluate team performance to ensure adherence to processes, regulatory compliance, and service standards.

• Ensure that production targets and quality benchmarks are achieved or surpassed.

• Address complex issues and act as a subject matter expert for specialized claims handling.

• Collaborate with managers and subject matter experts regarding escalated or unique claim matters.

• Offer management insights on workflow, priorities, and production challenges.

• Suggest and implement changes to policies, programs, and business processes.

• Verbally and in writing, report team activities to management.

• Foster prompt, accurate, and courteous service for both internal and external clients.

• Engage in projects and departmental assignments.

• Initiate and confirm daily check reports; manage stop payments, voids, overpayments, and liens.

• Recruit, select, and train claims-processing personnel.

• Coach, mentor, and provide performance feedback to examiners.

• Identify and spearhead training and staff development initiatives.

• Conduct timely and constructive performance evaluations.

• Develop and enforce corrective action plans.

• Assume managerial responsibilities in the absence of the Manager.

⛳️ Requirements

• A Bachelor’s degree and two (2) years of experience as a Claims Examiner is preferred.

• Previous experience in supervising, mentoring, training, and/or leading others is preferred.

• Capability to organize time, prioritize tasks, and manage workload effectively.

• Understanding of disability adjudication principles, methods, procedures, and current business practices.

• Proven ability and willingness to provide honest and constructive feedback.

• Familiarity with current federal and state laws related to leaves of absence.

• Knowledge of medical terminology.

• Demonstrating responsibility and reliability is essential.

• Ability to adapt to changes in the work environment.

• Exceptional supervisory skills in teaching, coaching, mentoring, and leading others.

• Strong interpersonal skills and the ability to establish effective working relationships with diverse stakeholders.

• Professional communication skills, both verbal and written.

• Independent problem-solving capabilities with the ability to analyze, interpret, and apply complex rules and regulations.

• Capacity to thrive in a fast-paced environment.

• Proficient in Microsoft Office applications (e.g., Word, Excel).

• Represent the ShelterPoint brand with the highest level of professionalism.

🏝️ Benefits

• Comprehensive health, dental, and vision insurance.

• Mental health benefits.

• Employee assistance program.

• Paid time off.

• Paid parental leave.

• Short-term disability.

• Cultural observance day.

• Contributions to healthcare accounts.

• Pension plan.

• 401(k) plan with company matching.

• ProHealth Rewards platform offering cash rewards.

• Annual incentive based on individual and company performance.