Senior Claims Manager

1 Month ago • 10-5 Years • $97,140 PA - $159,585 PA

Job Summary

Job Description

Guardian is seeking a Senior Claims Manager to oversee the medical aspects of the claim evaluation process within the Clinical Practice Group. This role involves aiding in the development of IDI Claims specialists, focusing on their business intuition, persuasive writing, and investigative skills to resolve complex claim and policy matters. The Senior Claims Manager will lead by example, provide actionable feedback, work with internal and external stakeholders, and drive innovation. Key responsibilities include solving complex problems, making timely and thoughtful decisions, analyzing contractual terms, medical, financial, occupational, and investigative issues, and ensuring accurate communications representing Guardian's values. The ideal candidate will possess strong problem-solving, decision-making, and prioritization skills, along with a solid understanding of Microsoft Office products.
Must have:
  • 10+ years disability insurance claim handling experience
  • 5+ years people leadership and management
  • College degree or diploma with strong claims management experience
  • Extensive knowledge of disability coverages
  • Advanced financial, medical, occupational, and investigative skills
  • Strong problem solving and decision-making skills
  • Ability to anticipate business challenges
  • Experience providing best-in-class customer service
  • Demonstrated experience prioritizing competing deadlines
  • Solid understanding of Microsoft Office products
Good to have:
  • Individual Disability Claims experience preferred
  • Clinical background preferred for management experience
Perks:
  • Skill-building opportunities
  • Leadership development
  • Philanthropic opportunities
  • Support and flexibility to achieve professional and personal goals
  • Opportunities to build communities and grow career
  • Diverse colleagues with high ethical standards
  • Contemporary, supportive, flexible, and inclusive benefits and resources

Job Details

At Guardian, we live our Purpose every day! As champions of wellbeing for ourselves, our communities, and consumers, we focus as a team to turn what's possible into a reality. We build experiences for you to grow and enrich your career and future as a Senior Claims Manager. We believe in your aspirations for purpose, leadership, and achievement in your professional and personal lives.


In the role of Senior Claims Manager of the Clinical Practice Group, you will utilize your claim adjudication background to oversee the medical aspects of the claim evaluation process. You will also aid in the development of IDI Claims specialists, with a focus on developing their intuition for business, persuasive writing, and investigative skills to resolve complex claim and policy matters.

If you are ready to bring your leadership experience, business acumen and innovative thinking, and represent Guardian with outstanding customer service, we will bring the support and resources to take your career to the next level. This is an opportunity to make an impact on the lives of our clients when they need it most, we are their Guardian!

You are


A manager to a team of nurses, claim specialists and administrators, as well as a panel of physicians located throughout the country. You will act with accountability and ensure quality and timely medical products are received to assist in making timely, fact-based claim decisions, in support of a high performing culture. You will aid in coaching and mentoring to help develop claims handling capabilities of claims specialists by enabling their critical thinking skills to assess rich policy features and nuanced fact patterns. You are skilled at ensuring timely and accurate decisions and best-in-class. You are passionate about growing your career and confident sharing ideas to continually improve both yourself and move the organization into the future.

You will


Be a leader

  • Lead by example.

  • Continuously focus on self-development and embrace feedback and change.

  • Provide actionable feedback that promotes future learning and success.

  • Work across business lines including both internal and external stakeholders.

  • Innovate and collaborate, challenging the status quo.

Be a decision maker

  • Ability to solve complex problems, while making timely, thoughtful decisions to resolve client issues.

  • Critical thinking skills are needed to analyze contractual terms, as well as medical, financial, vocational, and other issues.

  • Ensure timely and accurate communications that represent Guardian’s values.

  • Provide accurate claims decisions in a time sensitive and fast-paced environment, while adhering to regulatory guidelines.

You have

  • 10+ years disability insurance claim handling experience (Individual Disability Claims - preferred).

  • 5+ years people leadership and management (clinical background preferred but not required).

  • A college or university degree, or high school diploma with strong disability claims management experience.

  • Extensive working knowledge of disability coverages, as well as advanced financial, medical, occupational, and investigative skills associated with the management of individual disability claims.

  • Strong problem solving and decision-making skills including company representation in matters involving dispute.

  • The ability to anticipate internal and/or external business challenges.

  • Experience providing best in class customer service, to include in-person customer engagement.

  • Demonstrated experience prioritizing competing deadlines.

  • Strong problem solving and decision-making skills and ability to manage appropriate resources.

  • Solid understanding of Microsoft Office products, including Word, Excel, and Outlook.

Salary Range:

$97,140.00 - $159,585.00

The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation.

Our Promise

At Guardian, you’ll have the support and flexibility to achieve your professional and personal goals.  Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.

Inspire Well-Being

As part of Guardian’s Purpose – to inspire well-being – we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues. Explore our company benefits at www.guardianlife.com/careers/corporate/benefits. Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits.

Equal Employment Opportunity

Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.

Accommodations

Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Guardian also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact applicant_accommodation@glic.com.

Current Guardian Colleagues: Please apply through the internal Jobs Hub in Workday.

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About The Company

Every day, Guardian helps our 29 million customers realize their dreams through a range of insurance and financial products and services. Our Purpose, to inspire well-being, guides our dedication to the colleagues, consumers, and communities we serve. We know that people count, and we go above and beyond to prepare them for the life they want to live, focusing on their overall well-being — mind, body, and wallet. As one of the largest mutual insurance companies, we put our customers first. Behind every bright future is a GuardianTM.

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