Claims Examiner Manager

Tharp Consulting; Livonia (MI); On-site; USD 120,000 - 180,000; Full time

Job summary

Tharp Consulting is seeking a leader to steer the technical strategy for complex life insurance claims, including escalated, appealed, contestable, and litigation-related matters. This role partners with legal, compliance, underwriting, and risk to guide outcomes.

You will mentor claim examiners, drive modernization initiatives, and set standards for documentation and case handling to improve speed, accuracy, and compliance.

Qualifications

• Expertise in life insurance claims and contestable/litigation processes.
• Ability to lead technical strategy for complex, high-risk claims.
• Strong judgment and analytical skills for compliant determinations.
• Experience improving claims operations through modernization.

Responsibilities

• Drive technical claim decisioning to ensure fair, accurate, timely, and compliant outcomes.
• Provide strategic guidance on complex claims and support appeals, contests, and disputes.
• Coordinate end-to-end claim resolution with legal, compliance, underwriting, and risk.
• Mentor claim examiners on technical issues and case handling standards.
• Advance claims modernization initiatives to improve processes and tools.

Skills

Life insurance claims

Litigation processes

Stakeholder management

Cross-functional collaboration

Claims modernization

Job description

Role: Lead technical strategy for complex life insurance claims, with responsibility for escalated, appealed, contestable, and litigation-related matters.

Key Responsibilities

• Drive technical claim decisioning to ensure outcomes are fair, accurate, timely, and compliant.
• Provide strategic guidance on complex claims and support throughout appeals, contests, and disputes.
• Partner with legal, compliance, underwriting, and risk stakeholders to coordinate end-to-end claim resolution.
• Guide and mentor claim examiners on technical issues, documentation, and case handling standards.
• Advance claims modernization initiatives to improve processes, tools, and operational effectiveness.

Qualifications & Skills

• Strong expertise in life insurance claims, including advanced contestable and litigation processes.
• Ability to lead technical strategy for complex, high-risk claim matters.
• Excellent judgment and analytical skills to support compliant, accurate determinations.
• Strong cross-functional collaboration and stakeholder management skills.
• Experience improving claims operations through modernization and process enhancements.