AVP, A&H Claims

AVP, A&H Claims

• Location: USA – MA –Marblehead & GA-Atlanta
• Work Arrangement: Hybrid  
• The salary range for this role is:  $ 149,500-224.500

The Opportunity

The purpose of this role is to oversee the operational and technical aspects of a team of Accident & Health Claim Specialists, ensuring efficient handling of Medical Stop Loss claims through best practices. This role involves driving continuous improvement initiatives to enhance quality and service while building strong relationships with both internal stakeholders and customers.

Responsibilities:

• Establish methods and procedures to manage, supervise, and direct the claims operations in a cost-effective manner
• Set department goals and policies in conjunction with business plans to ensure objectives are met
• Identify, analyze, recommend and implement process improvements in functional areas
• Achieve specific key performance indicators and strive to find better ways to improve overall service delivery
• Act as a critical point of escalation on complex, denied or pending claims
• Maintain current knowledge of products and services to provide direction and respond to issues
• Cultivate positive relationships with internal and external customers to accomplish organizational goals
• Assess present and future resource needs for employees and provide the leadership, mentoring and guidance necessary to build and sustain a high performing workforce
• Manage budgeted resources by anticipating expenditures, accurately forecasting resource needs/costs and properly accounting for expenses to meet requirements and achieve fiscal responsibility

Work Experience:

Preferred Work Experience includes:

• 8 plus years of Accident & Health Medical Stop Loss claim experience required.
• 2 plus years of people management experience required.
• Significant exposure to high risk and/or high value Specific Excess Claims
• Experience reviewing Aggregate Accommodation requests and Aggregate Claim submissions.
• Highly proficient in Microsoft Office and the Connexure/ESL system.

Qualifications:

Necessary Qualifications include:

• Tertiary Degree or equivalent combination of education and work experience.

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Skills:

How to Apply:

To submit your application, click "Apply" and follow the step by step process.

Equal Employment Opportunity:

QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.