Sup. - STD Claims

Posted on May 18, 2019 by Reliance Standard

Portland, ME 04101
Information Technology
Immediate Start
Annual Salary
Full-Time
Job Description:

Purpose:
The Supervisor is responsible for ensuring that all claims assigned to his/her team are accurately and fairly adjudicated in a timely manner according to plan provisions, established best practices and within company, state and federal guidelines. The Supervisor is responsible for ensuring operational excellence and collaborates with other members of the management team to improve operations beyond his or her team.

Key Responsibilities:
Manage the prompt and accurate investigation, adjudication and payment (where appropriate) of claims within established guidelines
Delegate, distribute and monitor the workflow within the department to meet turnaround times, improve efficiency and realign caseloads to reduce or eliminate backlogs
Ensure that workflows, procedures, and best practices are followed to improve accuracy, efficiency, and effectiveness of claim management through focus reviews
Utilize available reporting resources and file reviews to ensure that established department goals are being met
Utilizes the file review and coaching process to continually improve and develop the examiners' skills relative to case strategy, decision-making, investigation, evaluation and communication.
Provides guidance and direction on claims presenting complex or unusual issues.
Ensures compliance with established procedures and assists with audit activities.
Suggest changes to policy language as necessary and participates in the development of new products.
Perform focus reviews and review Group Quality audit results
Accountable for performance of team; engages team members in talent management and development opportunities, and builds a positive and respectful work environment.
Makes personnel decisions on hiring, firing, discipline, transfer, advancement and promotion in accordance with Company policies and procedures.
Oversees the implementation and measurement of best practices to continually enhance the team's efficiency and effectiveness.
Models and drives RSL's values in the departments.
Any other job-related duty as deemed appropriate by management.

Qualifications:
2-year Degree; 4-Degree preferred
Completion of HIAA, LOMA or ICA courses desirable
5 years of relevant (transferrable) experience
Knowledge and experience working in group insurance with a focus on disability claims
Critical thinking and analytical skills with a passion for problem solving and resolution
Outstanding communication skills, able to listen and respond with professionalism and empathy, maintaining tact and diplomacy, often in stressful situations
Demonstrated ability to lead change management initiatives


Reference: 708078888

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