Paid Leave Claim Manager - Employee Benefits (Remote)

Protective; United States; Remote; USD 68,000 - 100,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

401(k) plan with company matching

Pension plan

Job summary

Protective in the United States is seeking a Manager Claims to oversee the day-to-day operations of an assigned claims examining team. The incumbent will supervise and advise examiners in all adjudication phases, ensuring quality, efficiency, and regulatory compliance across the team.

This role emphasizes leadership, coaching, and collaboration with senior management to drive performance, implement policy changes, and deliver exceptional service to internal and external customers.

Qualifications

• Bachelor’s degree preferred with two years experience as a Claims Examiner.
• Proven supervisory, mentoring, training and leadership experience.
• Strong organizational, time management and workload prioritization skills.

Responsibilities

• Oversees day-to-day operations of an assigned claims examining team.
• Supervises and advises examiners in all adjudication phases and monitors performance.
• Identifies workflow challenges and ensures adherence to processes and production goals.
• Resolves escalated issues, acts as SME, and implements policy changes.
• Provides feedback to management and helps develop department policies and strategies.

Skills

Supervisory experience

Leadership

Communication skills

Education

Bachelor’s degree

Tools

Microsoft Office

Excel

Job description

The work we do has an impact on millions of lives, and you can be a part of it.

Wehelp protect our customers against life’s uncertainties.Regardless ofwhere you work within thecompany, you’ll behelping provide protection and peace of mind when our customers need it most.

Job Summary:

Oversees the day to day operations of an assigned claims examining team/unit.

The incumbent will be responsible for supervising and advising claims examiners in all phases of the adjudication process and for the performance of each of the team’s members (e.g. team player, quantity, quality, etc.).

***This role will be titled Manager Claims within the organization.***

Responsibilities

• Supervises and advises claims examiners in all phases of the adjudication process.
• Schedules, assigns and oversees the work of their respective claim examiners. Quickly identifies and resolves workflow and caseload management challenges.
• Utilize knowledge to monitor the team’s output for: uniformity in the application of processes, compliant with regulations, and adheres to or exceeds departmental standards of service.
• Ensure team members achieve, and preferably exceed, ‘current’ departmental production goals and quality standards.
• Resolves issues above the skill set of the claim examiners (i.e. act as SME). Responsible for special handling policies/claims (i.e. white glove).
• Confers with manager and/or other SMEs to resolve escalated/unique claim related issues.
• Provides feedback to management on workflow, work priorities and production problems. Recommends changes. Works with other supervisors to develop policies and strategies to advance the work of the department.
• Implements required programmatic and business process changes/enhancements.
• Reporting to management on various activities of the team both verbally and in writing.
• Promotes a positive customer experience through prompt, accurate and courteous service to both internal and external customers.
• Contribute to positive work environment to ensure the achievement of departmental and corporate goals and objectives (outside of Claims).
• Participates in department’s various project work and assignments, as needed.
• Initiates production of daily check reports. Verifies that issued checks balance to control totals. Places stop payments and voids on all returned checks. Records all overpayments and liens, including phone follow-up.
• Participates in interviewing and selection of staff. Hires and trains staff involved in processing claims.
• Provides counsel, guidance and support to examiners regarding their performance, as measured by the performance standards of the department
• Identifies and leads in-service training and staff development needs. Provides ongoing coaching and mentoring.
• Conducts performance evaluations that are timely and constructive.
• Establish and implement corrective action plans, when necessary.
• Assumes delegated responsibilities when the Manager is unavailable for a material amount of time (i.e. out of office).

Qualifications/Education/Experience

• Represent the ShelterPoint brand with the utmost professionalism
• 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).

$68,000 - $100,000 a year

Protective’s targeted salary range for this position is $68,000 to $140,000. Actual salaries may vary depending on factors, including but not limited to, job location, skills, and experience. The range listed is just one component of Protective’s total compensation package for employees.

This position also offers additional incentive opportunitiesthrough an annual incentive based on individual and Company performance.

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Employee Benefits:

We aim to protect the wellbeing of our employees and their families with a broad benefits offering. In addition to offering comprehensive health, dental and vision insurance, we support emotional wellbeing through mental health benefits and an employee assistance program.Work/life balance is important and Protective offers a variety of paid time away benefits (e.g., paid time off, paid parental leave, short-term disability, and a cultural observance day).The financial health of our employees is just as important as physical and emotional health. Some of the financial wellbeing benefits include contributions to healthcare accounts, a pension plan, and a 401(k) plan with Company matching. All employees are encouraged to protect their overall wellbeing by engaging in ProHealth Rewards, Protective’s platform to improve wellbeing while earning cash rewards.

Eligibility for certain benefits may vary by position in accordance with the terms of the Company’s benefit plans.

Accommodations for Applicants with a Disability

If you require an accommodation to complete the application and recruitment process due to a disability, please email [e-mail]. This information will be held in confidence and used only to determine an appropriate accommodation for the application and recruitment process.

Please note that the above email is solely for individuals with disabilities requesting an accommodation. General employment questions should not be sent through this process.

We are proud to be an equal opportunity employer committed to being inclusive and attracting, retaining, and growing an inclusive workforce.