Claims Program Manager
Location
New Jersey
Posted
76 days ago
Salary
$58.7K - $110.2K / year
Seniority
Senior
Job Description
Claims Program Manager
Crum & Forster
• Assist in the creation of a relationship-based culture through a broad set of activities which include managing a diverse portfolio of medical products and administrators on an ongoing basis • Serve as a “next-step” liaison to administrative, operations, and underwriting areas of the company, on an ongoing basis • Utilize sensitivity tactics to address relevant issues with distressed customers in a professional manner, on an ongoing basis • Participate in team member’s meetings with clients and address all open issues no less often than quarterly • Address technical issues and coordinate with IT team to seek resolutions as needed • Assist with the Program Management Team’s onboarding of new clients as needed • Establish long term customer relationships through prompt and courteous service • Assist in Due Diligence of new program administration business, which includes onsite reviews and assessment, while providing Management an operational assessment of prospective partners • Conduct annual reviews of administrators to ensure compliance with company requirements, while identifying gaps in process and/or areas for potential improvement at both the administrator and company level • Monitor claims activity to identify any outliers, no less often than quarterly • Prepare monthly reporting packages, including but not limited to, inventory reporting, first level (TPA customer service & turnaround) statistics, and referral analysis (turnaround times, volume breakdowns) for review by VP / AVP / Director and Senior Level Management • Assist with the monthly analysis of all claims related litigation/regulatory inquiries and/or high dollar claims to identify all trends and exposure • Assist in the drafting and maintenance of reference documents for internal Claims Best Practices including: Standards – both C&F and regulatory, Procedures, Workflow
Job Requirements
- Bachelor’s Degree from an accredited university/institution
- 6+ years’ experience of relevant Medical Stop Loss or Medical Excess Experience
- Experience in specialty products such as Employer Stop Loss, Short Term Medical, Medical Excess, Fixed Indemnity, and Life is preferred
- Strong knowledge of Microsoft Office tools – Outlook, Excel, Word and PowerPoint
- Ability to work in a fast-paced environment and adaptable
- Ability to travel (up to 40%)
Benefits
- Competitive compensation package
- Generous 401K employer match
- Employee Stock Purchase plan with employer matching
- Generous Paid Time Off
- Excellent benefits that go beyond health, dental & vision.
- Our programs are focused on your whole family’s wellness, including your physical, mental and financial wellbeing
- A core C&F tenet is owning your career development, so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training to keep you progressing on your chosen path
- A dynamic, ambitious, fun and exciting work environment
- We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community
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