Globe Life · 16 hours ago
Supervisor, Health Claims (Remote)
McKinney, TX
Part-time
Remote
Mid, Senior Level
3+ years exp
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Responsibilities
Supervise team of 10+ Cancer & Other Health claims associates and oversee daily operations to ensure achievement of performance/productivity standards.
Understand, interpret, and effectively communicate contractual language in Cancer, Critical Illness, Accident, and Hospital Indemnity policies.
Provide expertise and leadership support to team in resolving complex claim issues.
Evaluate daily Workflow in Onbase platform and load balance claims as needed to ensure even distribution of work.
Review high cost claims and claims over the authority level of individual examiners for accuracy and compliance adherence.
Ensure each associate is equipped with the tools, knowledge and resources to be successful in their role while also recognizing training gaps and opportunities for retraining.
Provide constant feedback to associates and counsel on matters of performance, attendance, and/or conduct.
Ensure Mainframe & Onbase systems are functioning properly and partner with IT to address system issues.
Utilize effective written and oral communication to respond professionally and with a sense of urgency to escalated claim issues received via mail, fax, or email.
Proactively communicate with management regarding problems such as staffing, high/low work volume, emergency situations, etc.
Identify process improvement opportunities and use logic and reasoning to compare strengths/weaknesses of alternative resolutions.
Conceptualize innovative technical solutions that translate into efficiencies within the unit.
Develop and maintain strong relationships with cross functional partners in Policy Services, Customer Service, Agency Offices, and Legal to accomplish organizational goals.
Cultivate a positive high performing team by modeling cultural expectations of accountability, continuous improvement, collaboration, and creativity.
Motivate and provide development direction to team members while fostering an environment of continuous growth.
Support culture and employee engagement activities and promote employee development.
Delegate additional responsibilities and stretch assignments to high potential examiners to position them for successful advancement within the organization.
Perform off-cycle quality review claim audits to ensure proper coding, documentation, and compliance with regulatory standards.
Maintain and monitor diary of questionable, sensitive, or possible fraudulent claims.
Collaborate with management and Human Resources to develop action plans for underperforming associates and ensure adherence to progressive disciplinary guidelines.
Write value-based performance appraisals and conduct effective colleague performance discussions.
Support organizational training initiatives and ensure staff is updated on mandatory role-appropriate training.
Complete monthly/adhoc reports with data interpretation to identify trends and issues to facilitate management in strategic decision making.
Develop contingency plans to meet objectives during challenging circumstances (i.e. staffing shortages, high work volumes, system implementation, etc.).
Effectively present complex information to key stakeholders to influence acceptance of innovative suggestions.
Lead and partner on claims and other business projects as needed, concurrently with daily responsibilities.
Partner with the manager to retain staff and build bench strength within the organization to achieve overall turnover goals.
Interview, hire, and mentor new claims associates.
Qualification
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Required
Bachelor’s degree from a four-year college or university preferred; or 5-7 years related experience and/or training; or equivalent combination of education and experience.
3 or more years’ experience handling claims.
Supervisory experience, a plus.
Experience interpreting contractual language in Cancer, Accident, and Critical Illness policies.
High technical aptitude and ability to learn new systems quickly.
Strong problem-solving skills with ability to use combination of analysis, experience and judgment to develop feasible solutions.
Advanced analytical and interpretive skills.
Excellent time management skills, with the ability to work under rigorous deadlines.
Excellent presentation skills including ability to present complex ideas to upper management in a professional manner.
Strong knowledge of Microsoft Office Suite (Outlook, Excel, PowerPoint, Access, etc.).
Excellent oral and written communication.
Independent workers able to make autonomous decisions with minimal supervision.
Ability to adjust plans, goals, actions or priorities to meet changing situations and competing priorities.
Ability to take ownership of tasks, projects, and relationships and follow through on obligations.
Reliable and predictable attendance of your assigned shift.
Ability to work full-time and/or part-time based on the position specifications.
Benefits
Comprehensive health, dental, and vision insurance plans because we believe that taking care of your well-being is fundamental to your performance.
Robust life insurance benefits and retirement plans, including company-matched 401k and pension plan.
Wellness club reimbursements and gym discounts to help you stay on top of your health.
Paid holidays and time off to support a healthy work-life balance.
Developmental training programs to enhance your skills and career progression and unlock your full potential.
Company
Globe Life
Globe Life is an insurance company.
1001-5000 employees
Funding
Current Stage
Public CompanyTotal Funding
$250M2024-08-15Post Ipo Debt· $250M
2019-08-09IPO
Leadership Team
Frank Svoboda
Executive Vice President and Chief Financial Officer
M
Matthew Darden
Executive Vice President and Chief Strategy Officer
Recent News
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