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Please forward posts to Darci Chuba at dchuba@claim.org

Post 1

Company: North American Company & Midland National

Location: Des Moines, IA or Sioux Falls, SD

Title: Director, Claims & Benefits

Job Summary:

Provide leadership in a multi-company/multi-site environment for all areas of Annuity and Life Claims and Benefits ensuring a strong customer service culture is developed which provides timely and accurate service to the agents, beneficiaries and policyholders in support of the Company’s service, profit, growth and productivity objectives.

Essential Functions:

Set long term direction for Claims and Benefits taking into account technology advancements, system enhancements, personnel development, infrastructure needs, and the needs of our customers. Realize the impact the departmental direction on other areas of the organization.
Uphold internal procedures that comply with current state insurance and IRS regulations.
Manage Claims and Benefits departments to meet established service standards in conjunction with state and federal statutes.
Create and maintain a departmental environment, which embraces the corporate core values, Sammons Leadership Series (SLS) principles, and emphasizes our employee-owner culture.
Build strong relationship with internal teammates at all sites as well as the multiple field forces we serve. This requires strong interpersonal skills along with excellent communication skills.
Effectively lead managers, team leads and other personnel in the processing of Claims and Benefit functions ensuring the needs of the customer are kept in the forefront.
Partner with managers to establish departmental goals, objectives and monitor progress toward meeting or exceeding corporate goals for performance and quality.
Develop managers, team leads, and staff with a focus on the development of future leaders.
Monitor weekly reports of processed and carryover department work activity, and work with department managers to correct problems identified by these reports.
Provide weekly reports for tracking service levels.
Continually analyze current work methods and practices to ensure that a commitment to continual improvement is established within the department.
Provide oversight for establishing, documenting and maintaining departmental procedures. Ability to solve complex claims issues.
Balance all business decisions weighing the cost benefits of each to ensure that cost effective solutions are reached.
Manage the department to meet all requirements of Model Audit Rule (MAR).
Develop a yearly budget for department and control budget expense throughout the year.
Oversee reconciliation of all outstanding policy accounts.
Provide on-going developmental training to staff to improve technical expertise, product and industry knowledge.
Conduct regular meetings with staff to keep them informed and to solicit feedback to improve quality of service and efficiency of day-to-day business processes.
Coordinate and perform required Human Resource functions for all Administration employees.

Qualifications:

College degree or equivalent work experience
Must embrace and effectively shadow the corporate core values
Effective leadership, management, decision-making and motivational skills
Knowledge of Administration functions and how these functions inter-relate with our Agent Field Force, Policy Owners and other key areas of the Company
Knowledge and experience in claims and benefits administration
Strong interpersonal skills for relationship building
Excellent communication skills, including listening, oral and written
Ability to work effectively in a multi-company/multi-site environment
Must be flexible in coping with changing business environments
Strong analytical skills
Independent thinking skills to evaluate facts based on sound and mature judgment
Must demonstrate the ability to act independently within the context of corporate goals
Must be able to use one’s special knowledge and abilities to assist in developing and expanding the skill level of subordinate management staff
Strong project management skills
Expertise in company operating procedures and policies
Knowledge of MAR and ability to perform account reconciliation
Have or working toward AAPA and FLMI designations
Excellent Computer skills, PC and Access Database.
Candidates must pass the background screening process that is required for this position

To Apply:

Forward resume to Theresa Sherry at tsherry@sfgmembers.com or go to http://www.mnlife.com/ to submit an online application/resume under the Careers section.

Posted 01/30/12

Post 2

Company: Genworth Financial, Inc.

Locations: Lynchburg, VA

Title: Sr. Claims Examiner – RP13581

Genworth Financial, Inc. (NYSE: GNW) is a leading Fortune 500 insurance holding company dedicated to helping people secure their financial lives, families and futures. Genworth has leadership positions in offerings that assist consumers in protecting themselves, investing for the future and planning for retirement -- including life insurance, long term care insurance, financial protection coverages, and independent advisor-based wealth management -- and mortgage insurance that helps consumers achieve home ownership while assisting lenders in managing their risk and capital. Genworth has approximately 6,400 employees and operates through three divisions: Insurance and Wealth Management, which includes U.S. Life Insurance, Wealth Management, and International Protection segments; Mortgage Insurance, which includes U.S. and International Mortgage Insurance segments; and the Corporate and Runoff division. Genworth Financial, which traces its roots back to 1871, became a public company in 2004 and is headquartered in Richmond, Virginia. For more information, visit genworth.com.

Responsibilities

The Sr. Claims Examiner position is accountable for identifying, investigating, evaluating, obtaining and utilizing critical information required to accurately and objectively adjudicate complex Long Term Care claims.

Make claim eligibility determinations based on the claimant's contract and other information provided at time of claim as well as determining need for additional information to properly determine risk.
Effectively manage and prioritize a work queue and multiple job responsibilities in a fast-paced environment, frequently with aggressive deadlines.
Responsible for incoming and outgoing calls to claimants, Power's of Attorney, facilities and other person's or entities involved in the adjudication of a claim.
Accountable for recognizing and working within a structured environment with clearly defined SOPs to ensure consistency of claims practices and resolution.
Other duties as assigned, including surge coverage for the call center as needed.

Basic Qualifications

2-5 years claims adjudication experience.
Knowledge of medical terminology.
Effective communication.
Customer service orientation.

Preferred Qualifications

Experience in the allied health field such as RNs, physical and occupational therapists, home health care provider.

To Apply:

Please post for job number RP13581 at http://www.genworth.com/employment .

Posted 01/30/12

Post 3

Company: Munich Re

Location: Atlanta, GA

Title: Claims Examiner II - Individual Life Claims

The Individual Life Claim Department of Munich American Reinsurance Company is accepting applications for a Claims Examiner II reporting to the Individual Life Claim Manager. The responsibilities of the Claim Examiner II position include adjudication of high risk, complex and contestable life and/or health claims, making claim determinations and processing payments, as appropriate, while also assisting less experienced staff with claim adjudication and decision making. This position works closely with Account Representatives to manage client accounts, may assist with external quality claim reviews, prepares claim trend analysis, reports results, and participates in resulting action plans.

Qualifications:

5+ years experience adjudicating life insurance claims or Bachelor's Degree and 3-5 years experience adjudicating life insurance claims

How to Apply:

To apply please go to www.marclife.com.

Posted 01/23/12

Post 4

Company: Midland National Life Insurance

Location: Des Moines, IA or Sioux Falls, SD

Title: Lead Claims Investigator

Job Summary:

Review, investigate, approve/deny and settle or negotiate contestable life insurance claims and disputed annuity claims. Represent the company in litigated cases, and work as the liaison between Claims and Legal counsel. Develop and maintain reports to track claim trends and to mitigate risk to the company. Oversee the activities of the Claims Special Investigation Unit.

Essential Functions:

Review and investigate contestable claims and disputed annuity claims in a timely manner to reach a settlement; collaborate with Legal and make recommendations to legal staff in support of final annuity or life decision on contestable or disputed claims.
Oversee all cases of questionable claims, possible misrepresentation on an application or possible internal fraud investigation with the involvement of Internal Audit, Compliance, and Legal departments.
Document investigations and provide reports to other departments as requested; partner with third party investigators and experts as necessary to fully investigate the claim validity.
Determine the appropriateness of investigations and, when necessary, personally recommend the proper method of investigation by telephone or correspondence, and/or if investigations are to be made by outside services.
Review and prepare files for Underwriting, Medical Director and Legal department review; be familiar with rescission practices and procedures, detect suspect fraudulent claims and prepare files accordingly; provide expert consultation to other team members when necessary.
Communicate with policyholders, agents, attorneys, beneficiaries and other interested parties as required regarding the disposition of contestable and disputed claims; explain policy provisions and all matters pertaining to claim handling via telephone or in writing.
Act as advisor to the Compliance department as they respond to state insurance department inquiries.
Communicate with authorized parties regarding the adjudications of contestable and disputed claims.
Answer questions on complex claim situations and make decisions involving company action or practices in regards to threatened lawsuits.
Travel as necessary to resolve litigated, disputed and questionable claim cases.
Provide expert testimony in court cases, dispositions, interrogatories, bench trials, etc. as necessary.
Negotiate disputed cases with the aid of legal counsel.
Document policies and procedures for contestable and disputed claims; ensure that claim practices conform to company policies, standards and objectives.
Possess expert knowledge of state laws, regulations and requirements concerning those issues pertaining to annuity and life claim handling.
Keep abreast of the practices and procedures of other departments, particularly New Business, Underwriting, Legal and General Accounting and offer suggestions regarding claim issues when necessary.
Prepare, track and report contestable claims activity; represent claims on the Risk Committee and share activity with the committee; understand and report adverse claims trends to the committee.
Collaborate with Reinsurance Companies when negotiating a compromise death claim settlement.

Qualifications:

Minimum of 15 years Life and Annuity claims experience and college degree preferred
Demonstrated expert knowledge of contestable and disputed claim resolution
Demonstrated expert, highly developed, written and oral communication skills to communicate at all levels
Demonstrated strong negotiation skills
Demonstrated strong knowledge of the practices and procedures of other departments such as New Business, General Accounting, Actuarial, Legal, Risk Management, Underwriting and Marketing.
Expert knowledge of insurance industry policies and practices
Demonstrated expert knowledge of state laws, regulations and requirements regarding proper claim handling
Demonstrated above average organizational and project management skills
Demonstrated knowledge of Life Claims Reserves and the principles regarding these reserves
Demonstrated committed pursuit of industry designation such as ALHC, FLHC, FLMI, FALU, CLU, ChFC, AAPA, ACS, PCS
Demonstrated ability to give depositions or court testimony as a qualified expert and professional representing the organization
Must have the ability to handle multiple assignments simultaneously and must be self-motivated and work independently as well as part of a team
Ability to travel up to 25% annually

To Apply:

Forward resume to Theresa Sherry at tsherry@sfgmembers.com or go to http://www.mnlife.com/ to submit an online application/resume under the Careers section.

Posted 01/04/12

Post 5

Company: MetLife

Location: Bloomfield, CT

Job Title: Clinical Unit Leader

Manages nurses, behavioral health clinicians, and vocational rehabilitation consultants to ensure the effective and efficient delivery of clinical and vocational rehabilitation services to the disability claims organization. Works with the claims management team in the planning, enhancement, and implementation of work flow processes and claims administration which contribute positively to financial outcomes and customer service delivery.

Functional Responsibilities:

Teams with other Specialty Services Managers and Claim Unit Managers to develop and articulate a vision and plan for Clinical and Vocational Rehabilitation Programs
Leads the team to successfully meet business objectives.
Directs and motivates nurses, behavioral health clinicians, and vocational rehabilitation consultants in a professional and cost effective manner to contribute to successful claim resolutions
Assists management to analyze reports and outcomes, identify trends, and to recommend plans of action to insure effective and efficient use of clinical and vocational rehabilitation services
Serves as a liaison among the specialty services teams and claim management teams, collaborating with Claim Unit Managers, and Operations Managers, and Directors to ensure optimal delivery of services to internal and external customers
Actively participates in sales presentations to prospective and existing policyholders. Maintains positive customer service relationships
Manages and performs multiple projects to create opportunity and process to support change and improve business performance
Handles budgetary and financial planning aspects for assigned units. Performs other related duties as assigned or required

Supervisory Responsibilities:

Full people management responsibilities, including hiring, firing, promotions, performance and compensation management, and training and development.

Typical Experience:

Bachelor's degree; Registered Nurse license 5+ yrs. disability insurance case management experience; 2+ yrs. people management experience.

To Apply Please Contact:

Holly Warder
Senior Recruiter
SourceRight Solutions / MetLife
Office: 706-478-5500
hwarder@metlife.com

Posted 01/03/12

Post 6

Company: MetLife

Job Title: Operations Manager – Group Disability Operations

Summary

This position has overall leadership of the day to day operational responsibilities for 60-80 STD and FML Claim Specialists and direct management of 4-6 Unit Managers that support our Group Insurance customers. Responsibilities include planning, implementing and overseeing all claim and customer activities while ensuring the highest quality and service is delivered on every claim.

Functional Responsibilities

Accountable for the day to day execution and attainment of all operational metrics and plans (e.g., quality, service, production) and is able to drive results and accountability across all levels of the team.
Builds and manages effective partnerships with both internal and external customers and appropriately integrates customer needs with the strategic direction of the organization.
Fosters an environment that supports effective teamwork and cross-functional cooperation.
Effectively manages and communicates change and creates a culture where change is embraced and impact of change is aligned with the business priorities.
Creates an organizational environment where feedback is valued, and is a role model for providing and receiving feedback.
Provides future vision of success and related requirements for ongoing process improvement.
Champions new process technology initiatives impacting the claim teams and creates an environment for successful implementation.
Provides leadership on major initiatives and uses leadership role and knowledge to affect the work and direction of the claim organization.
Performs other related duties as assigned or required.

Supervisory Responsibilities

Full people management responsibilities, including hiring, firing, promotions, performance and compensation management, training and development.

Experience and Competencies

Bachelor's degree; solid claims experience with 5+ years of experience in leadership position
Demonstrated FML, STD and LTD skills and knowledge
Builds Relationships - Expert influence, negotiation and networking skills
Communicates Effectively - Demonstrated excellent verbal/written/presentation skills. Experience with the design and presentation of information to large audiences
Uses Sound Business Judgment - Demonstrated ability to analyze and resolve problems using sound business judgment. Be able to identify trends, and implement effective action plans to address improvement opportunities
Champions Change - Recognized as a Change Agent who proactively leads and embraces change with innovation, courage and resiliency
Inspires a Shared Vision.
Develops Talent for the Future.

To Apply, Contact:

Julie Hoepfner, Sr. Recruiter
SourceRight Solutions/MetLife
Toll-Free: 866-682-7051
801-298-1838
juliehoepfner@sourcerightsolutions.com

Posted 11/28/11

All postings will remain for 60 days unless otherwise noted

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