Combined Insurance, a Chubb Company, is seeking a Group Claim Adjudication Manager to join our fast-paced, high energy, and growing company. For nearly 100 years in the insurance industry, our company has been passionate about serving our customers and providing them peace of mind and protection when they need it the most. Come build your career here, along with other positive, hard-working, talented professionals—just like you! 

 

 

JOB SUMMARY:

 

Lead all key operating functions of a Group Claim Adjudication unit. Ensure that claims submitted are processed timely and accurately to meet all service and quality standards.  This includes monitoring and managing Adjuster workload, productivity, and accuracy and taking appropriate actions to mitigate any problems or issues that arise.  The role also provides vision and leadership for the development and implementation of various claim initiatives to improve and enhance the capabilities and performance of the Group Claims adjudication team and the service experience for our customers. 

 

 

RESPONSIBILITIES:

Ensure all Group Disability, Accident, Health, Critical Illness, other A&H or Life claims are processed and managed in compliance with key metrics around customer service to ensure achievement of departmental goals

Monitor, track and drive service, quality performance and productivity through metrics

Provide strategic leadership in the development, execution, and monitoring of claims adjudication policies, procedures, and initiatives that align with corporate goals and strategies Take a leadership role in assisting with the implementation of continuous improvement activities/projects for operational processes to increase efficiencies, enhance quality, reduce costs, standardize systems, and/or add value for both internal and external clientsUnderstand and monitor the end-to-end service experience for Group Claims customers, employer groups and brokers to identify problems and opportunities for improvementBuild and maintain strong relationships with brokers, employers, and other external partners to ensure consistent claims servicing and customer satisfaction Collaborate with and maintain a strong partnership with Chubb Workplace Benefits and sales leadership teams.  This includes ensuring timely and responsive communications regarding claims servicing inquires, problems, or issues and proactive management of root causes to eliminate future concernsProvide oversight, technical expertise, and partnership with Third Party Administrators 

Provide coaching and support to staff as needed to ensure quality and performance standards are consistently met

Promote a culture of high performance and continuous improvement that values learning and a commitment to quality

Collaborate with other departments within the company to resolve issues relevant to effective claim administration

Responsible for the preparation of various monthly, quarterly, and annual reports

Select, develop and retain talent 

Identify training needs or opportunities and coordinate with trainers to address 

Projects and duties as assigned

 

 

SKILLS:

Excellent interpersonal & communication skills

Ability to interact with customers and business partners in a professional manner 

Ability to make prompt, sound, decisions based upon analysis of complex issues

Results-oriented with ability to leverage data and information to monitor and improve resultsDemonstrated ability to motivate and support a claims adjudication team and maintain a positive, professional, and motivating work environment

Demonstrated ability to manage and build Broker and Client relationships in support of overall sales and service strategies and objectives

Strategic thinker with the ability to manage and lead change

Demonstrated ability to drive productivity and quality improvement programs as well as coaching for claims adjudication staffAdvanced knowledge of industry best practices and medical terminology

Strong working knowledge of Word, Excel, PowerPoint, and SharePoint 

Working knowledge of industry best practices, procedures and principles

Coursework in industry programs desirable (e.g. LOMA)

 

 

EDUCATION/EXPERIENCE:

Bachelor’s Degree or equivalent work experience

Minimum of five years of experience in the insurance industry, including two years supervisory experience

Experience and expertise with ERISA governed policies and claims 

Claim knowledge in Employer Benefits, Group Disability, Accident, Health and Life

Experience with online claim processing, imaging systems and workforce management applications

 

The pay range for the role is $66,900 to 113,700. The specific offer will depend on an applicant’s skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program.  Chubb offers a comprehensive benefits package, more details on which can be found on our careers website.  The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled.