Manager of Claims

Overview

Manages a significant portion of the operations of the Claims Department in accordance with various governmental laws and regulations and the by-laws of the Order. The responsibilities of a Manager include reaching prompt settlement of death and disability claims as defined by the terms of the insurance contracts; leading and managing claims processors including training, upskilling, coaching, and prioritizing work; resolving escalations on cases by dealing with beneficiaries, agents, or internal departments such as Legal and Compliance; supporting the design and implementation of future state of Claims.

Core Responsibilities

• Manages the activities of assigned units including directing, advising and managing direct and indirect reports; makes recommendations on hiring, performance appraisals and all related employment issues, including labor relations as it pertains to assigned units.
• Trains or provides appropriate training for supervisors and other employees related to claims processing and when new systems and procedures have been implemented; coaches, provides feedback, counsels and motivates employees.
• Reviews and authorizes payment of benefits in satisfaction of death and disability claims.
• Resolves escalations on specific claim cases by coordinating with beneficiaries, field agents, Legal, Compliance, or other parties.
• Responds to inquiries and contacts beneficiaries, attorneys, financial institutions or others concerned with claim benefit payments or alternative settlement options.
• Supports the creation of Claims vision and setting of department annual goals.
• Creates and instills a culture of continuous improvement throughout the department.
• Oversees process or system enhancements from a business perspective.
• Reviews medical data on denied waiver and death claims and prepares denial letters.
• Manages reinsurance reimbursement process and recommends changes; consults with Actuarial when necessary.
• Corresponds with physicians and health care facilities to obtain medical reports which are reviewed by the Medical Director in consultation with Legal to evaluate claims that fall within the two-year contestable timeframe. Serves on Claims Committee; presents, reviews and assists in resolving contestable claims.
• Assists in the preparation of reports for the Supreme Advocate and the portion of the Annual Statement as it pertains to Claims operations.

Skills Qualifications

Required:

• Experience with online systems and insurance master record
• Knowledge of federal and state estate tax laws pertaining to the distribution of benefits
• Knowledge of all KofC insurance plans, contracts and riders and related KofC and insurance regulations regarding beneficiaries and contractual rights of the insured and the company
• Must be customer service oriented with superior oral and written communication skills
• Mathematical skills
• Management skills or ability
• Research and problem-solving capabilities
• Analytical and critical thinking skills
• Leadership and vision

Systems/Technical Knowledge:

• Ingenium, Life70, DCLM, AWD
• Microsoft Office, including Word, Excel and PowerPoint
• Lexis-Nexis, Social Security Index, TLOxp and other online systems for research

Education

Required:

• BS or BA in related field
• 10-15 years related work experience preferably in insurance with some lead/supervisory experience or equivalent combination of training and experience

Preferred:

• LOMA or ICA certification preferred

Compensation

The wage range for this role takes into account a broad array of factors that are considered in making compensation decisions, including but not limited to: skill sets; experience and training; licensure and certifications; and other business and organizational needs.  The range below applies as long as the work is performed in Connecticut; the Knights of Columbus reserves the right to adjust the wage range if the position is performed in another location.  At the Knights of Columbus, it is not typical for an individual to be hired at or near the top of the range for their role, and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $69,600-$115,000.

Physical Demands

Authorization to work in the United States is required

This position is not eligible for visa sponsorship