Manager - Employee Benefit Claims

About the role

We are seeking a Claims Manager to lead a team of Claims Examiners and drive operational excellence within our claims organization. This role will play a key part in restructuring team workflows, improving claims intake and escalation processes, and partnering closely with contact center operations. The ideal candidate brings strong employee benefits (EB) and group claims experience, along with a proven track record of leading high-performing teams and implementing process improvements. This is a hands-on leadership opportunity for someone who can hit the ground running, support organizational transformation, and help shape the future state of the claims function.

Responsibilities

• Plans and organizes the work of Examiners.
• Reviews work in progress as well as conducts audits to ensure quality.
• Involved in State Insurance Department audits.
• Handles personnel actions including interviewing, hiring, firing, performance reviews, salary recommendations, and coordinates training and development.
• Enforces company rules fairly and impartially.
• Reviews more complex cases and settles or initiates further action within approved authority limits.
• Serves as a technical resource to subordinates and others in the organization.
• Monitors performance, progress, schedules, and costs.
• Involved in fraud identification and training.
• Testifies at depositions, hearings, and trials.
• Assists and maintains claim loss and reserve records and reports on claims in relationship to company business and industry standards.
• In collaboration with Vice President, establishes overall department budget; allocates resources within department; manages department activities to budget.
• Involved in various projects involving the system, acquiring business, etc.
• Maintains positive, proactive relationships with clients, agents and other internal departments to meet service objectives.
• Negotiates and monitors relationships with outside investigative firms and death claim payments through banks.

Qualifications

• Bachelor’s degree or equivalent work experience required.
• Minimum of 5 years of claims experience.
• Demonstration of management ability.

Preferred Qualifications

• Leadership skills which fosters an environment of respect, support, and growth within team and peers.
• Problem solving and analytical skills.
• Excellent oral and written communication skills.
• Strong organizational skills.
• Ability to research and interpret information for the completion of claims as well as projects; self-starter; ability to multi-task.

Working Conditions

Hybrid Environment

Pay

The salary for this position generally ranges between $84,000–$99,000. This range is an estimate, based on potential employee qualifications, operational needs and other considerations permitted by law. The range may vary above and below the stated amounts, as permitted by Colorado Equal Pay Transparency Rule 4.1.2.

This position is also typically eligible for an Annual Bonus based on the Company Bonus Plan/Individual Performance and is at Company Discretion.