JOB DESCRIPTION

Combined Insurance, a Chubb Company, is seeking a Worksite Claim Adjudication Manager to join our fast-paced, high energy, and growing company. For nearly 100 years in the insurance industry, our company has been passionate about serving our customers and providing them peace of mind and protection when they need it the most. Come build your career here, along with other positive, hard-working, talented professionals-just like you!

JOB SUMMARY:

Lead all key operating functions of a Worksite Claim Adjudication unit. Ensure that claims submitted are processed timely and accurately to meet all service and quality standards. This includes monitoring and managing Adjuster workload, productivity, and accuracy and taking appropriate actions to mitigate any problems or issues that arise. The role also provides vision and leadership for the development and implementation of various claim initiatives to improve and enhance the capabilities and performance of the adjudication team and the service experience for our customers.

RESPONSIBILITIES:

• Ensure all Disability, Accident, Health, Critical Illness, other A& H or Life claims are processed and managed in compliance with key metrics around customer service to ensure achievement of departmental goals
• Monitor, track and drive service, quality performance and productivity through metrics
• Provide strategic leadership in the development, execution, and monitoring of claims adjudication policies, procedures, and initiatives that align with corporate goals and strategies
• Take a leadership role in assisting with the implementation of continuous improvement activities/projects for operational processes to increase efficiencies, enhance quality, reduce costs, standardize systems, and/or add value for both internal and external clients
• Understand and monitor the end-to-end service experience for claims customers, employer groups, brokers, and agents to identify problems and opportunities for improvement
• Build and maintain strong relationships with brokers, agents, employers, and other external partners to ensure consistent claims servicing and customer satisfaction
• Collaborate with and maintain a strong partnership with sales leadership teams. This includes ensuring timely and responsive communications regarding claims servicing inquires, problems, or issues and proactive management of root causes to eliminate future concerns
• Provide oversight, technical expertise, and partnership with Third Party Administrators
• Provide coaching and support to staff as needed to ensure quality and performance standards are consistently met
• Promote a culture of high performance and continuous improvement that values learning and a commitment to quality
• Collaborate with other departments within the company to resolve issues relevant to effective claim administration
• Responsible for the preparation of various monthly, quarterly, and annual reports
• Select, develop and retain talent
• Identify training needs or opportunities and coordinate with trainers to address
• Projects and duties as assigned

COMPETENCIES

• Problem Solving: Takes an organized and logical approach to thinking through problems and complex issues.Simplifies complexity by breaking down issues into manageable parts.Looks beyond the obvious to get at root causes.Develops insight into problems, issues and situation.
• Continuous Learning: Demonstrates a desire and capacity to expand expertise, develop new skills and grow professionally.Seeks and takes ownership of opportunities to learn, acquire new knowledge and deepen technical expertise.Takes advantage of formal and informal developmental opportunities.Takes on challenging work assignments that lead to professional growth
• Initiative: Willingly does more than is required or expected in the job.Meets objectives on time with minimal supervision.Eager and willing to go the extra mile in terms of time and effort. Is self-motivated and seizes opportunities to make a difference.
• Adaptability: Ability to re-direct personal efforts in response to changing circumstances.Is receptive to new ideas and new ways of doing things.Effectively prioritizes according to competing demands and shifting objectives.Can navigate through uncertainty and knows when to change course
• Results Orientation: Effectively executes on plans, drives for results and takes accountability for outcomes.Perseveres and does not give up easily in challenging situations. Recognizes and capitalizes on opportunities.Takes full accountability for achieving (or failing to achieve) desired results
• Values Orientation: Upholds and models Chubb values and always does the right thing for the company, colleagues and customers.Is direct truthful and trusted by others.Acts as a team player.Acts ethically and maintains a high level of professional integrity.Fosters high collaboration within own team and across the company; constantly acts and thinks "OneChubb"

SKILLS:

• Excellent interpersonal & communication skills
• Ability to interact with customers and business partners in a professional manner
• Ability to make prompt, sound, decisions based upon analysis of complex issues
• Demonstrated ability to manage and build Broker, Agent and Client relationships in support of overall sales and service strategies and objectives
• Strategic thinker with the ability to manage and lead change
• Advanced knowledge of industry best practices and medical terminology
• Strong working knowledge of Word, Excel, PowerPoint, and SharePoint
• Working knowledge of industry best practices, procedures and principles
• Coursework in industry programs desirable (e.g. LOMA)
• Results-oriented with ability to leverage data and information to monitor and improve results
• Demonstrated ability to motivate and support a claims adjudication team and maintain a positive, professional, and motivating work environment
• Demonstrated ability to drive productivity and quality improvement programs as well as coaching for claims adjudication staff

EDUCATION/EXPERIENCE:

• Bachelor's Degree or equivalent work experience
• Minimum of five years of experience in the insurance industry, including two years supervisory experience
• Experience and expertise with ERISA governed policies and claims
• Claim knowledge in Employer Benefits, Group Disability, Accident, Health and Life
• Experience with online claim processing, imaging systems and workforce management applications

ABOUT US

OUR BENEFITS

As a Chubb corporate employee, you have access to one of the most comprehensive benefit plans in the business, designed to meet your needs and help you reach your financial goals. More details can be found here. Chubb is committed to supporting its employees with a comprehensive compensation package that is appropriate in the market where they work. Below are several of the many benefits we offer our employees:

• Health insurance
• Dental insurance
• Tuition reimbursement
• A company-match 401(k) plan
• Disability insurance
• Life insurance
• Employee referral bonuses

ABOUT COMBINED INSURANCE

Combined Insurance Company of America is a Chubb company and a leading provider of supplemental accident, health, disability, and life insurance products in North America. Headquartered in Chicago, with satellite office in Columbia, SC, Combined is celebrating over 100 years in business. We are committed to making the world of supplemental insurance easy to access and understand. The company has an A+ rating by the Better Business Bureau and an A + (Superior) financial strength rating by A.M. Best. We are ranked by VIQTORY as the number one Military Friendly® Employer in 2023 (over $1 billion revenue category), marking Combined's twelfth consecutive year on the Top 10 list. We pride ourselves on approaching all situations with a Positive Mental Attitude (PMA) and encouraging collaboration.

ABOUT CHUBB

Chubb is a world leader in insurance. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.

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