Offer summary

Qualifications:

Bachelor’s degree in a relevant field or equivalent experience in management and medical insurance claims., Minimum of 2 years of management experience in the medical insurance claims sector, with an option to substitute 4 years of relevant work experience for the degree., Strong knowledge of health information technologies, medical coding systems, and insurance regulations., Excellent communication, analytical, organizational, and interpersonal skills..

Key responsabilities:

Lead and manage the Claims team to ensure timely and accurate claims processing while meeting production standards.

Supervise team activities including hiring, training, performance evaluation, and work allocation.

Manage processes for efficiency and support business initiatives through collaboration and resource sharing.

Develop and oversee the annual budget and provide processing metrics to track performance.

Job description

Pan-American Life Insurance Group (PALIG) is seeking a Claims Manager to join the U.S. Benefits department.

The Claims Manager will be accountable for providing leadership to the Claims team by organizing, managing, and directing personnel and workflow to achieve timely and accurate disposition of claims, while maintaining production standards and quality results.

ESSENTIAL FUNCTIONS:

Business Quality Management

Plan, schedule, and direct the activities of the 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

Team Management

Provide effective supervision, including hiring, training, scheduling, approving personnel timecards and personal time off, problem resolution, and work allocation
Be responsible for evaluating the performance of team members, making recommendations for appropriate action where necessary, and motivating team members to achieve peak performance and productivity
Continue the education and development of team members to adapt to sales deviations and business restructuring
Maintain a reliable staffing model to ensure appropriate staffing levels

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 and enhancements
Provide input into strategic decisions that affect the functional area of responsibility
Resolve escalated issues arising from operations and requiring coordination with other teams
Support corporate strategic initiatives internally and externally
Seek process improvements to increase automation and efficiency gains

Expense Management

Develop and manage the annual budget
Provide daily, weekly, and monthly processing metrics

Other Duties as Assigned

KEY REQUIREMENTS:

Bachelor’s degree, plus 2 years of experience in management and medical insurance claims required (4 additional years of relevant work experience may be substituted in lieu of degree)

KNOWLEDGE, SKILLS & ABILITIES (KSA's):

Possess current knowledge of technologies in the health information sector and their applications
Possess working knowledge of CPT, ADA, HCPCs and ICD-10 codes, UB-04 claim forms, 1500s, HIPAA, medical terminology, X12 837 transactions, insurance regulations, and insurance benefits
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

Pan-American Life Insurance Group Offers:

Comprehensive Compensation Packages (base & bonus)
Comprehensive Benefits Package: Medical, Dental, 401K, Paid Time Off, and Tuition Reimbursement, etc. are some examples. New hires are eligible for medical and dental coverage on the first of the month following 30 days of service.

Who We Are:

Pan-American Life Insurance Group (PALIG) serves the life, accident, and health insurance needs of individuals and businesses in 49 U.S. states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands through its U.S. based member companies - Pan-American Life Insurance Company and Pan-American Assurance Company.

At Pan-American Life, our employees are our greatest asset. We are grateful for the collaborative efforts of our employees and partners, and for the confidence of the policyholders whose life and health we protect. It is through this long-standing commitment that Pan-American Life continues to succeed.

Pan-American Life is an Equal Opportunity Employer/Drug Free Workplace.

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