Claims Manager

Pan-American Life Insurance Group (PALIG) is seeking a Claims Manager to join the U.S. Benefits department.

The Claims Manager will be responsible for providing leadership to the Claims team by organizing, managing, and directing personnel and workflow to ensure timely and accurate claims disposition, while maintaining production standards and quality results.

Essential Functions:

Business Quality Management

• Plan, schedule, and direct the activities of claims processors to achieve service performance and retention targets
• Position the team for successful management of both new and existing products
• Provide effective oversight of third-party administrators and other business partners
• Participate in the due diligence process as needed

Team Management

• Provide effective supervision, including hiring, training, scheduling, approving timecards and PTO, resolving problems, and allocating work
• Evaluate team member performance, make recommendations for appropriate actions, and motivate team members to achieve peak performance and productivity
• Support continued education and development of team members to adapt to sales deviations and business restructuring
• Maintain a reliable staffing model to ensure appropriate staffing levels

Process Management

• Manage processes to achieve maximum efficiency while maintaining service standards
• Support business initiatives through resource sharing and collaboration
• Participate in IT prioritization processes and provide oversight of IT projects and enhancements
• Provide input into strategic decisions affecting the functional area of responsibility
• Resolve escalated issues arising from operations and requiring coordination with other teams
• Support corporate strategic initiatives internally and externally
• Identify and recommend process improvements to increase automation and efficiency

Expense Management

• Develop and manage the annual budget
• Provide daily, weekly, and monthly processing metrics

Other Duties as Assigned

Education & Experience:

• Required: Bachelor’s degree, plus 2 years of experience in management and medical insurance claims (four additional years of relevant work experience may be substituted in lieu of a degree)

Knowledge, Skills & Abilities (KSAs):

• Current knowledge of technologies in the health information sector and their applications
• Working knowledge of CPT, ADA, HCPCs and ICD-10 codes, UB-04 claim forms, 1500s, HIPAA, medical terminology, X12 837 transactions, insurance regulations, and insurance benefits
• Excellent written and oral communication skills
• Self-starter with strong analytical, organizational, and time management skills
• Strong interpersonal skills
• Ability to work with matrix partners and manage competing deadlines

What We Offer:

• Competitive compensation package (base salary & bonus)
• Comprehensive benefits, including medical, dental, 401(k), paid time off, and tuition reimbursement
• Medical and dental coverage effective the first of the month following 30 days of service
• Hybrid work opportunities

About Us:

Pan-American Life Insurance Group (PALIG) serves the life, accident, and health insurance needs of individuals and businesses across 49 U.S. states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands through its U.S.-based member companies—Pan-American Life Insurance Company and Pan-American Assurance Company.

At PALIG, our employees are our greatest asset. We value collaboration, trust, and the confidence of our policyholders. Our long-standing commitment to excellence continues to drive our success.

Pan-American Life is an Equal Opportunity Employer and a Drug-Free Workplace.