Claims Manager

Position Overview

• Location Type: [Not Specified]
• Employment Type: Full Time
• Salary: [Not Specified]

The Claims Manager at Pan-American Life Insurance Group (PALIG) will be responsible for leading the Claims team, overseeing claim processing, and ensuring timely and accurate claim disposition while maintaining production standards and quality results. This role involves managing personnel, workflow, and third-party administrators.

Requirements

• Education: Bachelor’s degree required. (4 additional years of relevant work experience may be substituted in lieu of degree)
• Experience: 2+ years of experience in management and medical insurance claims required.
• Knowledge:
  • Current knowledge of technologies in the health information sector.
  • Working knowledge of CPT, ADA, HCPCs, ICD-10 codes, UB-04 claim forms, 1500s, HIPAA, medical terminology, X12 837 transactions, insurance regulations, and insurance benefits.
• Skills:
  • Excellent written and oral communication skills.
  • Self-starter with strong analytical, organizational, and time management skills.
  • Strong interpersonal skills.
  • Ability to work with matrix partners and manage competing deadlines.

Responsibilities

• Team Management:
  • Provide effective supervision, including hiring, training, scheduling, approving personnel timecards, and managing personal time off.
  • Evaluate team member performance and make recommendations for appropriate action.
  • Motivate team members to achieve peak performance and productivity.
  • Continue the education and development of team members.
  • Maintain a reliable staffing model.
• Process Management:
  • Manage processes to achieve maximum efficiency while maintaining service standards.
  • Support business initiatives through resource sharing and collaboration.
  • Participate in IT prioritization processes and provide oversight of IT projects.
  • Provide input into strategic decisions.
• Issue Resolution:
  • Resolve escalated issues arising from operations.
  • Coordinate with other teams to resolve complex issues.
• Business Quality Management:
  • Plan, schedule, and direct the activities of claims processors to achieve service performance and retention targets.
  • Position the team for successful management of new and existing products.
  • Provide effective oversight of third-party administrators and other business partners.
  • Participate in due diligence process as needed.
• Other Duties:
  • Support corporate strategic initiatives internally and externally.
  • Seek process improvements to increase automation and efficiency gains.
  • Develop and manage the annual budget.
  • Provide daily, weekly, and monthly processing metrics.

Application Instructions

[Not Specified - Please refer to PALIG's career website for application instructions.]

Company Information

Pan-American Life Insurance Group (PALIG)

Offers:

• Comprehensive Compensation Packages (base & bonus)
• Comprehensive Benefits Package: Medical, Dental, 401K, Paid Time Off, and Tuition Reimbursement.