- Supervise and advise claims examiners throughout the adjudication process
- Schedule, assign and oversee claim examiner workloads
- Monitor team output for consistent processes, regulatory compliance and service standards
- Ensure production goals and quality standards are met or exceeded
- Resolve complex issues and serve as a subject matter expert for special-handling claims
- Consult with managers and SMEs on escalated or unique claim issues
- Provide management feedback on workflow, priorities and production problems
- Recommend and implement policy, programmatic and business-process changes
- Report team activities to management verbally and in writing
- Promote prompt, accurate and courteous service to internal and external customers
- Participate in projects and departmental assignments
- Initiate and verify daily check reports; process stop payments, voids, overpayments and liens
- Interview, select and train claims-processing staff
- Coach, mentor and provide performance guidance to examiners
- Identify and lead training and staff-development initiatives
- Conduct timely, constructive performance evaluations
- Establish and implement corrective action plans
- Assume delegated Manager responsibilities when the Manager is unavailable
Requirements
- Bachelor’s degree and two (2) years experience as a Claims Examiner is preferred.
- Prior experience in supervising, mentoring, training and/or leading others is preferred.
- Ability to organize time, set priorities, and manage workload.
- Knowledge of disability adjudication principles, methods, procedures and current business practices
- Demonstrated ability and willingness to give candid and meaningful feedback
- Knowledge of current federal and state laws pertaining to leaves of absence
- Knowledge of medical terminology
- Being Responsible and Reliable is a must
- Ability to adapt to change
- Excellent supervisory skills – teaching, coaching, mentoring and leading others.
- Excellent interpersonal skills and ability to build effective working relationships with a variety of constituencies
- Professional verbal and written communication skills
- Independent problem-solving skills - ability to analyze, interpret and apply rules and regulations of considerable complexity
- Ability to work in a fast pace environment
- Proficient in Microsoft Office (i.e. Word, Excel).
- Represent the ShelterPoint brand with the utmost professionalism
Core Competencies
Demonstrates expertise in supervising and mentoring claims examiners while ensuring compliance with disability adjudication principles and federal and state laws. Proficient in managing workloads, providing constructive feedback, and implementing process improvements to enhance team performance and service standards.
Highest-signal resume keywords
- Claims Examination Supervision
- Disability Adjudication Knowledge
- Performance Management
- Regulatory Compliance
- Microsoft Office Proficiency
Hard Skills
- Claims Adjudication
- Policy Implementation
- Workflow Management
- Training and Development
- Performance Evaluation
- Problem Solving
- Medical Terminology
- Time Management
- Feedback Delivery
- Process Improvement
Soft Skills
- Interpersonal Skills
- Coaching
- Mentoring
- Communication Skills
- Adaptability
Industry Keywords
- Federal Laws
- State Laws
- Leaves of Absence
- Service Standards
- Claims Processing
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Paid Leave Claim Manager – Employee Benefits Arbeitgeber: Jobtailor
Als Front Office Supervisor in unserem dynamischen Team bieten wir Ihnen die Möglichkeit, in einem unterstützenden und freundlichen Arbeitsumfeld zu wachsen. Wir legen großen Wert auf die berufliche Entwicklung unserer Mitarbeiter und bieten regelmäßige Schulungen sowie die Chance, Verantwortung zu übernehmen. Unsere Lage ermöglicht es Ihnen, Teil einer lebendigen Gemeinschaft zu sein, während Sie gleichzeitig die Standards unseres Franchise-Partners einhalten und unseren Gästen einen unvergesslichen Aufenthalt bieten.
