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Manager, STD Claims

at OneAmerica

Posted: 9/21/2019
Job Status: Full Time
Job Reference #: 08a61411-282c-4228-98a0-9ed6324ddfec

Job Description

At OneAmerica, we deliver on promises when customers need us most.  We believe the best way to serve our customers is to know that every individual, employee, family and business we work with has unique personal and financial goals.  We keep our promises, so we can help them achieve their goals and realize their definition of financial success.

The Manager, STD Claims is responsible for contributing to the overall success of OneAmerica’s objectives by providing timely and accurate support to our policy holders and the Claims department. This role will focus on meeting all key financial business objectives and enhance customer service levels for assigned team. The Manager, Short-Term Disability Claims will focus on effectively managing the performance of all individuals to achieve optimal productivity and strive for quality through accurate and timely claim decisions This individual will also maintain clear and ongoing communications with other business partners, inside and outside of claim department, such as QA, Appeals, Training Team, Program Managers, Policy and Procedures, Underwriting, Legal, etc.  

The purpose of the Manager, Short-Term Disability Claims is to provide leadership and coaching to claims staff and maintain a positive impact on employee staffing and retention levels by participating in recruiting, hiring and retention strategies.

KEY RESPONSIBILITIES:

  • Consistently adhered to the documented workflow guidelines and established procedures.
  • Assured consistent, quality claims handling by review of pending claim, diary and Change of Definition reports.
  • Responds to and tracks all Insurance Department complaints.
  • Actively participates in review of claims for approvals/denials.
  • Conducts one-on-one meetings with all claims staff on a monthly basis.
  • Conducts timely, accurate performance assessments for all team members. Such assessments include a 6-month interim as well as an annual performance review.
  • Partners with Supervisors in mentoring all staff to acceptable proficiency levels.
  • Personally documents and addresses all performance management issues and communicates those to the Director of Claims.
  • Interfaces weekly with Supervisor to remain abreast of team member performance and on-going training needs.
  • Monitors caseloads to maintain consistency within team.
  • Analyzes claim activity reports to ensure adherence to turn-around times, workflow guidelines, etc.
  • Supports/develops supervisors’ technical and mentoring capabilities.
  • Ensures the Team provides excellent customer service by appropriately adjudicating claims within established service protocols.
  • Responds to and documents customer complaints from claimants/their representative, clients and policyholders
  • Ensures quality claim decisions in accordance with ERISA requirements and fair claim practices through participation in Team Meetings.
  • Participates in customer presentations and visits with the goal of retaining existing customers and attaining new customers at the request of the Director of Claims.
  • Reaches or exceeds approved quality rating requirements.
  • Displays a high level of leadership through employee development, coaching and performance management.
  • Strives to timely utilization of appropriate resources across the benefits organization.
  • Participates in cross-departmental initiatives to enhance the overall effectiveness of the company at the request of the Director of Claims.

REQUIREMENTS:

  • Four-year college degree or a combination of equivalent related work experience and education.
  • A minimum of 5 years of experience managing disability claims strongly preferred.
  • Prior managerial experience required.
  • Desired designations include: ICA (Insurance Claims Associate); HIA (Health Insurance Associate); LOMA, FLMI (Fellow Life Management Institute); CEBS (Certified Employee Benefit Specialist); etc.

 

To learn more about our products, services, and the companies of OneAmerica, visit oneamerica.com/companies.

Disclaimer:  OneAmerica is an equal opportunity employer and strictly prohibits unlawful discrimination based upon an individual’s race, color, religion, gender, sexual orientation, gender identity/expression, national origin/ancestry, age, mental/physical disability, medical condition, marital status, veteran status, or any other characteristic protected by law.