Operations Manager, Claims Specialist

2 weeks ago

Montpelier, Vermont, United States National Life Group Full time
Job Summary

The Claims Team Manager is a key leadership role within National Life Group's Claims Team, responsible for driving the execution of team objectives, service delivery, and expectations. This individual will maintain an advanced working knowledge of claims procedures, policies, and system applications, as well as company life and annuity product features.

Key Responsibilities
  • Drive the execution of team objectives, service delivery, and expectations by planning, organizing, and directing team members.
  • Participate in strategic planning to develop departmental operational plans to maximize the department's efficiency, productivity, and performance.
  • Develop an internal talent pipeline, by setting team and individual goals, coaching for performance and individual growth and development.
  • Partner with stakeholders across the organization to drive large scale initiatives and champion successful change implementation to create value.
  • Provide claims examiners with ad hoc support for escalations and claims with the highest complexity.
  • Coordinate with leadership, sales, legal, compliance, reinsurance, underwriting, and actuarial to maintain the contractual provisions and company practices for claim adjudication and to minimize potential litigation.
  • Mentor and support technical training of examiners and participate in cross-organizational claim education.
  • Commit to professional growth and development, including participating in industry conferences and maintaining industry relationships.
Requirements
  • 10+ years of industry experience as a Claims Examiner or Underwriter, preferably in Life, Annuity, Disability, Long Term Care or Health insurance.
  • 5+ years of management experience, with a demonstrated ability to direct others, including developing, training, and executing performance goals.
  • A comprehensive understanding of claims appeals, denials, medical terminology, and contract language.
  • Exceptional leadership, team management, and interpersonal communication skills.
  • Bachelor's degree preferred, but applicants of various backgrounds are encouraged to apply.
  • Preferred background includes insurance industry and business process designations such as ALMI, FLMI, ALHC, FLHC, and CLU.
  • Proficiency with life insurance industry core systems, including claims, enterprise content management, and customer relationship management, as well as collaboration platforms.
Competencies
  • Customer focus - deliver the highest standards of quality service through effective and compassionate listening, communication, and responsiveness.
  • Business and technical acumen - maintain a working knowledge of computer information systems, insurance contract features and regulatory rules, and medical terminology.
  • Managing and organizing work - clearly assigning responsibilities and expectations, setting objectives and monitoring progress and results.
  • People development - coordinate the development of claims examiners by coaching, monitoring progress, and providing feedback.
  • Building effective teams - bringing together a mix of skillsets and fostering team cohesiveness to create a group that is stronger than the sum of the individuals.
  • Data analysis - applying broad knowledge and perspective to articulate insights into business results.
  • Organizational agility - understand cross-functional operations and leverage relationship network.
  • Critical thinking - apply judgment and exercise sound reasoning to make and support claim decisions.
What We Offer

National Life Group offers a competitive total rewards package, including a 401(k) retirement plan match, medical, dental, and vision insurance, a company-funded wellness account, 10 paid holidays, a generous paid time off plan, 6 weeks of paid parental leave, and 6 weeks of paid family leave after a year of full-time employment.

National Life Group is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to creating an inclusive and respectful work environment that values diversity, equity, and inclusion.

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