Claims Manager manages the operations of an insurance claims department to meet operational, financial, and service requirements. Oversees the intake and processing of insurance claims for personal, property, or casualty loss based on coverage, appraisal, and verifiable damage. Being a Claims Manager manages appraisal and examination staff and processes. Assures timely and proper disposition of claims based on policy provisions. Additionally, Claims Manager recommends and implements best practices to ensure complete and thorough claim settlements, legal reviews, and investigations following company policies and insurance industry regulations. Determines the value of settlements for escalated claims. Manages negotiations of settlements and administration of claims in litigation. Typically requires a bachelor's degree. Typically reports to a director. The Claims Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a Claims Manager typically requires 5 years experience in the related area as an individual contributor. 1-3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)
Job description
For more than 50 years, BEST Life and Health Insurance Company has been one of the nation’s leading insurance carriers specializing in ancillary employee benefit plans and individual ACA dental. We are currently seeking a Claims and Customer Service Manager to work full-time in our newly remodeled Corporate Offices located in Meridian, Idaho. The top applicant will have a minimum 3 years of customer service experience in a call center environment and at least 1 year in a supervisory role or lead position. If you meet any of these qualifications and want to work with the BEST company in the Boise, ID area, please send us your resume!
SUMMARY:
This position will ensure claims and customer service teams function with a high level of efficacy by supervising customer service and claims staff. Lead and manage the day-to-day customer service activities of providing services to members, healthcare providers, plan administrators and brokerage community using available systems and timely communication with staff in Idaho and California by performing the following duties.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
· Provide excellent service to claims examiners in the day-to-day claims support functions and assists claims leadership with various duties, projects, training events and administrative functions as requested.
· Give clear and concise direction to customer service representatives in day-to-day duties.
· Facilitate training for new hires and existing staff.
· Offer feedback to staff regarding performance of duties.
· Suggest improvements to processes for the office and staff.
· Manage and review new hire selections and performance review.
· Handle escalated call situations.
· Develops and implements clear procedures and processes related to Customer Service Department, Claims Department , office and other areas as needed
· Ensures operation efficiency of office staff as needed; oversees communications and strategic planning related to office administration
· Manages facility in coordination with other departments, including all aspects of office space/infrastructure for office building (eg., inside and outside appearance, moves, changes, etc..) vendor contracts and relationships
· Manages office supplies
· Weekly and monthly reporting
· Other duties as assigned.
EDUCATION/EXPERIENCE: Educational degrees must be from a US Department of Education accredited school.
· High School Diploma AND
· At least one (1) year experience in the medical/health/life insurance industry
· At least three (3) years of customer service experience in a call center environment with minimum of 1 year supervisor or lead position.
· Two (2) year college (Associate’s Degree).
· Knowledge of HIPAA regulations preferred.
· Spanish speaking a plus, but not required.
Office Manager Qualifications/Skills:
· Must have good communication skills and be able to work closely with our Executive team and employees.
· Delegation
· Staffing
· Promoting process improvement
· Reporting Skills
· Comply with all safety policies, practices and procedures. Report all unsafe activities to supervisor and/or Human Resources.
· Provide leadership to others through example and sharing of knowledge/skill.
· Strong organization skills.
· Ability to work under pressure in high volume area, and meet strict deadlines.
· Ability to work independently with great sense of urgency.
Benefits of working with us include:
Job Type: Full-time
Pay: From $75,000.00 per year
Benefits:
Physical setting:
Schedule:
Ability to commute/relocate:
Experience:
Work Location: In person
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