Waco, TX 76796
Posted at 30 Nov, 2023
Life Claims Manager - Hybrid
The Claims Manager is responsible for being a subject matter expert in the field of Life claim adjudication. This position will be responsible for developing a team consisting of Escalation Claims Support, Staff Support (trainer/lead) and AIL Claims Support. The AIL Life Claims Manager is also responsible for overseeing, leading, directing, and motivating the team while providing technical/jurisdictional direction for accurate and timely claim adjudication. Under moderate management, the manager will coordinate work tasks and ensure staff is aligned with business needs. The incumbent will also be charged with building strong relationships with business partners to meet organizational goals and fostering an environment that optimizes productivity. This could include working directly with agents, policyholders, and/or multiple parties that may be involved in a claim. This position will be responsible for overseeing of all training plans deployed for all life claims staff, in partnership with our audit and oversight manager. The position will be an expert in all life claims products, overseeing claims activities relating to claims and in support thereof. This includes some technical support (such as, implementing new software tools), claims examination and product management along with the responsibility for executing the company's claims strategy and meeting key performance indicators (for example, claim turnaround time, quality, and expense projections).
Manage team of AIL Life Claims Support associates, Escalation Claims Support, Staff Support who oversee daily operations to ensure achievement of performance/productivity standards
Understand, interpret, and effectively communicate contractual language in Life and Accident policies
Provide expertise and leadership support to team in resolving complex claim issues
Evaluate daily Workflow in OnBase platform and load balance claims as needed to ensure even distribution of work as it relates to Claims Support and Escalations
Ensure each associate is equipped with the tools, knowledge and resources to be successful in their role while also recognizing training gaps and opportunities for retraining
Provide constant feedback to associates and counsel on matters of performance, attendance, and/or conduct
Ensure Mainframe & OnBase systems are functioning properly and partner with IT to address system issues
Utilize effective written and oral communication to respond professionally and with a sense of urgency to escalated claim issues received via mail, fax, or email
Proactively communicate with management regarding problems such as staffing, high/low work volume, emergency situations, etc.
Identify process improvement opportunities and use logic and reasoning to compare strengths/weaknesses of alternative resolutions
Conceptualize innovative technical solutions that translate into efficiencies within the unit
Develop and maintain strong relationships with cross functional partners in Policy Services, Customer Service, Agency Offices, and Legal to accomplish organizational goals
Write value-based performance appraisals and conduct effective colleague performance discussions
Support organizational training initiatives and ensure staff is updated on mandatory role-appropriate training
Complete monthly/adhoc reports with data interpretation to identify trends and issues to facilitate management in strategic decision making
Develop contingency plans to meet objectives during challenging circumstances (i.e. staffing shortages, high work volumes, system implementation, etc.)
Lead and partner on claims and other business projects as needed, concurrently with daily responsibilities
Partner with Claims Supervisor to retain staff and build bench strength within the organization to achieve overall turnover goals
Interview, hire, and mentor new claims associates
Conceptualize innovative technical solutions that translate into efficiencies within the unit
Some travel may be required
Experience interpreting contractual language in Life and Accident policies
Strong problem solving skills with ability to use combination of analysis, experience and judgment to develop feasible solutions
Excellent time management skills, with the ability to work under rigorous deadlines
Excellent presentation skills including ability to present complex ideas to upper management in a professional manner
Education & Work Experience Required:
~ Bachelor's degree from a four-year college or university preferred; or 5-7 years related experience and/or training; 3 or more years' experience handling claims and data entry background
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