Claims Program Manager
New
United StatesFull-TimeManager
Salary58,700 - 110,200 USD per year
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Job Details
- Experience
- 6+ years
- Required Skills
- Microsoft OfficeComplianceRelationship managementData analytics
Requirements
- Bachelor’s Degree from an accredited university/institution.
- 6+ years of relevant Medical Stop Loss or Medical Excess experience.
- Proficiency in Microsoft Office tools (Outlook, Excel, Word, PowerPoint).
- Ability to travel up to 40%.
- Strong analytical and data-driven decision-making skills.
- Excellent organization and time management abilities.
- Ability to work both independently and in a team environment.
Responsibilities
- Manage a diverse portfolio of claim clients (Third Party Administrators and Managing General Underwriters).
- Identify and resolve operational process issues for clients and the company.
- Perform due diligence and operational assessments of prospective program administration partners.
- Conduct annual audits of administrators to ensure compliance.
- Monitor claims activity to identify outliers and processing issues.
- Prepare monthly reporting packages including inventory and referral analysis.
- Coordinate with IT, Underwriting, Actuarial, and Compliance teams.
- Maintain internal Claims Best Practices documentation.
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