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

Post 1

Company: Prudential

Location: Positions available in Denver, Colorado and Northern New Jersey/New York City area.

Job Title: Special Investigator

The Special Investigation Unit of Prudential Financial has two current openings for Life Insurance Field Investigators. These positions report to the Director, Special Investigations and will be responsible for conducting field investigations of life and disability claims and Underwriting matters. We are looking for experienced, self-motivated, independent, conscientious, dedicated professional investigators with the highest degree of honesty and integrity. These positions will be responsible for investigations in a multi-state area, and therefore must be willing to travel.

Has responsibility for accurate detection and the in-depth investigation of life insurance matters. Presents impartial results to management for management decision making. Performs field work, interacts with insurance industry fraud units, claim personnel, counsel, law enforcement agencies or others as relevant to the investigation. May provide evidence and testify in cases where law enforcement agencies pursue prosecution. May develop program awareness or conduct training seminars on the detection, deterrence and prevention of fraud; may conduct investigative research for company personnel and agents.

One position will need to be based in the Northern New Jersey/New York area, and the other in the Denver, Colorado area.

The selected candidates will work remotely from a home office. No relocation assistance is provided.

Requires a minimum of 5 years of field investigation experience, prior SIU experience is desired.
Excellent communication skills, both oral and written.
Strong computer skills are required. Working knowledge in the use of Lotus Notes, MS Word, Internet and Internet research capabilities are a must.
Ability to work with minimal supervision, a flexible work schedule and travel within a multiple state area.
Proven time management and organizational skills.
Ability to office from their home.

To Apply:

Apply thru the Prudential website here (search for job # SPE00008)

Posted 06/18/13

Post 2

Company: New York Life Insurance Company

Location: Cleveland, OH

Job Title: Corporate Vice President, Claims Management (Life & Annuity)

Job Function and Key Duties & Responsibilities

The Life & Annuity Claims management team is looking for an experienced Senior Claims Manager to join their team. The role is located in Cleveland, but will report to senior management in New York. This officer level role will be responsible for providing leadership and expert oversight to NYL’s life, annuity and waiver claims, as well as provide management guidance and direction to a team of managers and claims reps in a call center environment.

Responsibilities:

Direct oversight of senior claims analysts and managers.
Responsible for achieving all service level standards set by management while being focused on operational excellence.
Involved in establishing the strategic direction of the claims team including coaching, training, quality control, staffing and recruiting.
Directly manage the execution of initiatives and strategies that deliver a superior customer experience.
Is accountable for the performance and results of the team.
Provides guidance to employees, internal and external customers and/or colleagues, including senior management in achieving targets and strategic plans.
Reviews and adjudicates complex claims.
Works closely with the Claims Senior Management team. Interacts directly with Agents, Field Office Senior Management, Underwriting, Technology and Office of the General Counsel.
Coordinates responses to Chairman, Executive Officer, beneficiaries, agents and attorneys.
Meets regularly with the NYL Senior Leadership Team to discuss strategic issues, project prioritization and staff development.
Identifies and resolves moderately complex problems within claims.

Required Qualifications:

Minimum of 10 years Life Claims or Life Insurance Operations experience
Bachelor’s degree preferred
Requires advanced understanding of practices and procedures in Life Claims or Life Insurance Operations and basic knowledge in other disciplines.
A proven background in a leadership role with experience managing and developing a team
Ability to conceptualize, plan and organize
Ability to deal effectively and successfully with senior management
Strong written and oral communication skills including presentation skills.

To Apply:

Please search for job ID# 7843 on the following website:

http://www.newyorklife.com/corporatecareers

Posted 06.03.13

Post 3

Company: CUNA Mutual Group

Location: Madison, WI, or remote anywhere across the U.S.

Job Title: Claim Specialist

Role Description:

Highly advanced Claims role requiring specialized depth and/or breadth of expertise; working independently, is responsible for administration of the largest, most complex or financially significant claims. May lead functional teams or projects and serve as internal consultant in the application of claims guidelines and contract interpretation as well as establishment and evaluation of performance standards. Recommends best practices and identifies innovative solutions to complex problems.

Job Responsibilities

Deal / communicate directly with 3rd parties and customers in the Investigation, negotiation and conclusion of highly complex and sensitive claims in accordance with established procedures
Ensure subrogation opportunities are maximized
Manage use of external adjuster activity to investigate claims
Evaluate / approve /pay claims up to pre-approved limit ($250,000) dependent on products serviced
Some independent travel required (up to 20%)

Job Requirements

Bachelor’s Degree in insurance or business or applicable experience
7+ years experience in P&C claims with emphasis in Commercial 1st Party Property and General Liability claims
Professional Certification desirable: CPCU, AFSB, CFE, SCLA
Other certifications, exams / licensing as be required
Excellent oral/written communication skills
Demonstrated excellent analytical & problem solving skills / decision making ability
Demonstrated mathematical aptitude
Demonstrated ability to interpret medical and insurance documentation
Leadership skills—with strong emphasis on influencing, demonstrating courage, and orientation to achieve desired results
Intellectual curiosity and the desire to learn

To Apply:

Please apply directly through our career site here

Posted 05/13/13

Post 4

Company: CUNA Mutual Group

Location: Waverly, IA or remote in IA, NE, IL, MN

Job Title: Sr. Claim Professional

Role Description

Advanced Claims role; under instruction, guidance, and direction from others. Responsible for the routine investigation, review and settlement of complex life insurance claims by use of existing procedures.

Job Responsibilities

Deal/communicate directly with beneficiaries and customers in the investigation and review of contestable life insurance claims in accordance with established procedures
Analyze claims to determine the need for additional investigation
Evaluate/approve/pay claims up to pre-approved limit dependent on products serviced

Job Requirements

Bachelor’s Degree in Insurance or business or applicable experience
3 + years customer service experience including demonstrated customer service skills
3+ years life insurance claim processing experience
Excellent oral/written communication skills
Demonstrated excellent analytical & problem solving skills/decision making ability
Demonstrated mathematical aptitude
Demonstrated ability to interpret medical and insurance documentation
Appropriate certifications, exams/licensing as required
Intellectual curiosity and the desire to learn
Self-motivated/self-starter

To Apply:

Please apply directly through our career site here

Posted 05/13/13

Post 5

Company: AIG Benefit Solutions

Job Location: Neptune, NJ

Job Title: Claims Examiner A&H

Performance Profile: Claims Examiner A&H
(Claims Examiner I Group, CLAE0493, grade 15)
March 2013

Organization and Position Summary

In January 2012, Chartis and SunAmerica Financial Group formed a significant new player in the benefits market by combining American General Life Companies’ Benefit Solutions division with the Medical Excess and @Work groups from Chartis Corporate Benefits division. The combined entity targets the employee and affinity group markets, and will serve as a one-stop solution for today’s changing benefits marketplace for groups of all sizes. The product suite includes life/AD&D, BTA/accident, universal and term life, dental, vision, limited healthcare, medical reimbursement, stop-loss, organ transplant, group hospital, group and personal disability, critical illness, accident and cancer insurance. This broad and diverse portfolio provides limitless opportunities to create flexible benefit offerings suitable for all sizes and budgets, and the combined underwriting, distribution and sales strengths of American General and Chartis provides further strength and differentiation in the marketplace.

The Claims Examiner performs all functions necessary to properly adjudicate Group Health claims in an automated environment in accordance with established company procedures and State Insurance Department regulations. Standards for production and accuracy must be met and surpassed consistently. The Claims Examiner provides service to customers/clients via ability to communicate claim payment or denial details in a concise, professional manner.

Immediate Performance Objectives

Process claims of varying difficulty at a level consistent with the production and quality standards (99% financial accuracy) set by the department.
Investigates, either by direct correspondence or investigative sources, eligibility or other policy qualifications as necessary to determine claim liability.
Approves claims within scope of authority; current limit - $10,000.00.
Answers telephone inquiries relative to new, pending or settled claims; communicates in a tactful, courteous and knowledgeable manner.
Prioritize work to meet established production standards.
Identify claims requiring additional review and direction by senior examiner, supervisor or technician.
Identify opportunities for cost savings such as case management, coordination of benefits and possible contracted or negotiated discounts.

Additional Objectives

Evaluate and recommend approval or other course of action where claims exceed approval authority.
Participate in and contribute to unit meetings.
Participate in special department projects as needed.

Candidate Profile

College degree or high school diploma combined with 1 to 2 years medical claims experience in an automated environment.
Some formal insurance education desired. Ability to self study and pass licensing exams as required by the various states/company within specified time frames.
Ability to read and interpret documents such as insurance policies, treatment plans, supervisor instructions and procedural manuals.
Good technical and investigative skills; understanding of insurance and medical terminology.
Proficient knowledge of computers, including use of software available.
Working knowledge of Microsoft Excel and Word.
Proficient written communication skills.

To Apply:

Please email Elizabeth Sutphin at Elizabeth.Sutphin@aig.com

Posted 04/29/13

Post 6

Company: AIG Benefit Solutions

Job Location: Neptune, NJ

Job Title: Claims Examiner Sr - Life and AD&D

Performance Profile: Claims Examiner Sr - Life and AD&D
(Claims Examiner II Group, grade 17, CLAE0492)
March 2013

Organization and Position Summary

Process Life and AD&D claims to determine claim liability. Correspond with policyholders, agents, claimants, attorneys and others for information needed for claim resolution. Provide customer service by answering telephone calls concerning Life and AD&D claims.

Immediate Performance Objectives

Investigate, either by direct correspondence or investigative sources, to determine insurance eligibility, policy requirements, as necessary to determine liability for Life and AD&D claims.
Manage a case load of Life and AD&D claims.
Answer telephone inquiries regarding new, pending and settled claims.
Communicate with policyholders, brokers, claimants, beneficiaries, attorneys and others regarding claim requirements or explanation of claim actions.
Approves or denies claims within scope of authority.
Calculate benefit and enter and verify data in Claim system to ensure accurate claim payment and financial reporting.
Refers claim and claim related questions, where appropriate, to Legal and/or Compliance departments.
Refers claims for possible recission to Medical Underwriting.
Reviews medical records when necessary to determine cause of death or medical history.
Performs projects as assigned.
Comply with all regulations.
Handle and resolve consumer complaints as assigned.

Additional Objectives

Review and approve work of other examiners as assigned.
Participate in claim system testing as assigned.

Candidate Profile

Minimum of 3 years Group Life and AD&D claims experience.
Experience in conducting claim investigations for both contestable Life and AD&D.
Knowledge of medical terminology.
Bachelors degree or equivalent work experience.
Excellent communication skills, both oral and written.
Competency in Microsoft Office software.
Ability to work independently.
Ability to effectively manage time.

To Apply:

Please email Elizabeth Sutphin at Elizabeth.Sutphin@aig.com

Posted 04/29/13

Post 7

Company: Lincoln Financial Group

Job Location: Omaha, Nebraska

Job Title: Dental Claims, Supervisor

About the Company

Lincoln Financial Group is a Fortune 500 company offering a diverse range of financial services and solutions. With a strong focus on four core business areas - life insurance, annuities, retirement plan services, and group protection - our business is built around supporting, preserving, and enhancing our customer's lifestyles and providing better retirement outcomes. Led by over 8,000 employees, Lincoln Financial provides the tools and advice to help individuals take charge of their futures.

The Role

As a Dental Claims Supervisor, you will provide focused and detailed leadership for the Dental claims team and work closely with the AVP to ensure fair, ethical and timely management of all claims. You will lead Dental Claims team by forecasting and planning for future events and communicating management goals and expectations. You will also manage day-to-day operations of team, interviews, hires and trains employees; plans, assigns and directs work; appraises performance; rewards and coaches employees; addresses complaints and resolves problems.

Responsibilities

Supervisory

Oversees Dental Claims team to organize the unit's structure and manage overall results. Assigns work flow of team to ensure accurate and efficient response time.
Supports AVP, Life & Dental Claims in creating vision and influencing necessary changes for Dental Claims team.

Communication

Communicates and interfaces with management across Group Protection on behalf of the Dental Claims team, secures organizational cooperation for needed changes.
Keeps priorities in focus with the needs and expectations of the customer.
Builds on existing relationships and trust, and inspires teamwork to encourage skill building and risk taking.

Talent Management

Recruits and hires talent for the Dental Claims team.
Leads Dental Claims team by coaching and developing employees.
Operations
Plans, strategizes and manages claims inventory and production operations.
Monitors overall metrics for team productivity and quality and works with the AVP on results initiatives.
Responds and handles escalated issues (workflow, claims, technical and personnel).
Participates in system enhancements and determines how it will impact the team.
Identifies improvements and implement procedural changes.
Makes financial decisions as they relate to claim management.
Stays current on claim procedures, standard dental practices and legal requirements.
Translates changes in business environment to opportunities for the organization.
Requirements

Education

Undergraduate degree or 4+ years of comparable work experience
Experience
3-5 years of experience in supervisory and claims that directly aligns with the specific responsibilities for this position.
A demonstrated track record of consistently meeting and/or exceeding performance expectations.
Possesses a bias for action and avoids workplace distractions.
Drives performance targets to completion.

Lincoln Financial Group ("LFG") is an Equal Opportunity employer and, as such, is committed in policy and practice to recruit, hire, compensate, train and promote, in all job classifications, without regard to race, color, religion, sex (including pregnancy), age, national origin, disability, sexual orientation, gender identity and expression, veterans status, or genetic information. Opportunities throughout LFG are available to employees and applicants and are evaluated on the basis of job qualifications. We have a drug free work environment and we perform pre-employment substance abuse testing.

To Apply:

Please apply online here

Posted 04/24/13

Post 8

Company: Lincoln Financial Group

Job Location: Atlanta, Georgia or Omaha, NE

Job Title: Long-term Disability Benefits Supervisor

About The Company

The Role

As a Long-term Disability Benefits Supervisor, you will be responsible for supervising administrative support staff.

Responsibilities

Operations and General Management

Manage day-to-day operations of the long-term disability team
Develop and maintain close customer ties, articulate customer needs, keep priorities in focus with the desires and expectations of the customer
Inspire teamwork to encourage skill building and risk taking
Work closely with clinical and vocational rehabilitation staff to ensure effective and appropriate clinical support and return to work activities are performed
Monitor overall metrics for their team's productivity
Accountable for making financial decisions as they relate to claim management
Work with Disability Claims Manager and Lead Benefit Specialist in influencing changes in disability claims organization

Talent Management

Responsible for recruitment, selection and training
Develop claims staff through coaching and counseling

Requirements

Education

Undergraduate degree or 4+ years of comparable work experience
Experience
3-5+ years of experience in Claims Services that directly aligns with the specific responsibilities for this position; including managerial, supervisory, and/or demonstrated leadership experience
Educational experience and/or proficiency in: Life Insurance, Medical terminology, Contracts, IBM Software, Supervisory experience
A demonstrated track record of consistently meeting and/or exceeding performance expectations
Possesses a bias for action and avoids workplace distractions
Drives performance targets to completion

To Apply:

Please apply online here for the position in Omaha, NE

Please apply online here for the position in Atlanta, GA

Posted 04/24/13

Post 9

Company: Lincoln Financial Group

Job Location: Omaha, Nebraska or Atlanta, Georgia

Job Title: Manager, Disability Claims

About the Company

The Role

As the Manager, Disability Claims, you will have overall responsibility for the performance of both STD and LTD claim teams serving a specific region of the country working closely with the AVP of Disability Claims in ensuring the fair, ethical and timely management of all Disability Claims generated from their region of responsibility. This position will be located in Omaha, Nebraska or Atlanta, Georgia.

Responsibilities

Strategy

Responsible for setting the direction for an Integrated Disability Region, ensuring profitability and influencing the direction of the region.
Leads region by forecasting, planning and budgeting for future events, organizing the units structure, communicating management goals and information.
Assists AVP in creating vision and influencing necessary changes for Disability Claims.
Understands the "big picture" and able to translate changes in business environment to opportunities for organization.

Talent Management

Responsible for recruiting and hiring Disability Supervisors and Benefit Specialists.
Responsible for the professional development of the Disability Supervisors.
Oversees Integrated team to organize the units structure and is responsible for overall results.

Communication

Communicates and interfaces with management on behalf of the Disability Claims teams, secures organizational cooperation for needed changes.
Develops and maintains close customer ties, articulates customer needs, keeps priorities in focus with the desires and expectations of the customer.
Builds on existing relationships, builds trust, and inspires teamwork to encourage skill building and risk taking.
Build partnerships with regional offices and home office business units.
Make presentations to brokers, employers, and potential and existing clients.
May manage National Accounts, Non-National Accounts or both.

Requirements

Education

4 Year / Bachelors Degree or equivalent work experience

Experience

Five to seven years of previous insurance or related experience, STD and LTD disability claims preferred.
Completion of Group AHIP, LOMA, ICA and other industry courses are desirable.
Working knowledge of strategic and tactical business planning, forecasting, budgeting, auditing techniques, accounting and management controls.
Strong attention to detail, highly organized and ability to prioritize and meet deadlines.
A demonstrated track record of consistently meeting and/or exceeding performance expectations.
Possesses a bias for action and avoids workplace distractions.
Drives performance targets to completion.

Any unsolicited resumes/candidate profiles submitted through our web site or to personal e-mail accounts of employees of Lincoln Financial Group are considered property of Lincoln Financial Group and are not subject to payment of agency fees.

Lincoln Financial Group ("LFG") is an Equal Opportunity employer and, as such, is committed in policy and practice to recruit, hire, compensate, train and promote, in all job classifications, without regard to race, color, religion, sex (including pregnancy), age, national origin, disability, sexual orientation, gender identity and expression, veterans status, or genetic information. Opportunities throughout LFG are available to employees and applicants and are evaluated on the basis of job qualifications. We have a drug free work environment and we perform pre-employment substance abuse testing.

To Apply:

Please apply online here

Posted 04/23/13

Post 10

Company: Lincoln Financial Group

Job Location: Omaha, NE

Job Title: Life & Dental Claims Policies & Practices Manager

About The Company

The Role

As the Life & Dental Claims Policies & Practices Manager, you will plan and prioritize the implementation of process improvements and policy changes enhancing delivery of Life and Dental Claims operations. You will support initiatives to improve claim management practices, sales support, vendor relationships, and product development. As the PPM, you will analyze internal claims practices and industry trends to continuously improve GP’s position in the marketplace.

Responsibilities

Project Management

Lead and participate in projects and initiatives that support enterprise strategic objectives, direct participation and engagement of Life and Dental subject matter experts working on strategic projects.
Coordinates with the BSO and SPO for the delivery of strategic projects and programs to ensure coordination of Life & Dental claims efforts with other GP initiatives.
Translate process improvements into appropriate language for policies and procedures, and coordinates with L&PD and other stakeholders in refining, revising, and training related to policies and practices.

Strategy

Collaborates with AVP, Life & Dental claims to create vision, influence necessary changes and foster 1 Team, 1 Goal culture.
Researches insurance industry data and competitive practices to facilitate a progressive view of GP’s positioning in relation to future trends in the market.
Interact with all levels within the organization, including senior management to research and resolve strategic and functional issues.

Consultant

Consults with the AVP, Life & Dental Claims, and leaders in other business areas to understand business needs and desired outcomes of initiatives related to Life & Dental Claims operations
Oversight of vendors (EDI, paper claim, and claim review services). Ensures resolution of file, reporting, quality, and invoicing issues.
Researches system(s) and processes and holds initial discussions with project sponsors to ensure they fully understand the requirements and have looked at alternatives.

Essential Duties and Responsibilities:

Education

Undergraduate degree or 4+ years of comparable work experience
Experience
5+ years of appropriate experience including managerial, supervisory, and/or demonstrated leadership experience; or 9+ years of equivalent work experience
1 - 3 Years Experience with Life and Dental claims practices, and familiarity with or ability to rapidly acquire knowledge of Life and Dental claims policies, practices, regulation, and public policy.
3 - 5 Years Experience in project management, literature research, and data analysis
3 - 5 Years Experience in the insurance industry ( individual, group, Life, ADD, STD, LTD, Dental, HMO/PPO, customer support, claims or other relevant business area)

To Apply:

Please apply online here

Posted 04/23/13

All postings will remain for 60 days unless otherwise noted

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