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Insurance Claims Specialist

$84k - $99k

UMC Health System

We are seeking a Claims Manager to lead a team of Claims Examiners and drive operational excellence within our claim's 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 insure quality. Involved in State Insurance Dept. audits. Handles personnel actions including interviewing, hiring, firing, performance reviews, salary recommendations, and coordinates training and development. Enforce 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. Assist and maintain claim loss and reserve records and report on claims in relationship to company business and industry standards. In collaboration with Vice President, establish overall department budget; allocate resources within department; manage department activities to budget. Involved in various projects involving the system, acquiring business, etc. Maintain positive, proactive relationships with our clients, agents and other internal departments to meet service objectives. Negotiate and monitor relationships with outside investigative firms and death claim payments through banks. Qualifications Bachelors 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 Compensation: 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. Bonus Eligibility: This position is also typically eligible for an Annual Bonus based on the Company Bonus Plan/Individual Performance and is at Company Discretion. Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment visa at this time. What We Offer For eligible employees, we offer a comprehensive benefits package designed to support both the personal and financial well-being of our employees. Competitive Pay Bonus for Eligible Employees Benefits Package Pension Plan 401k Match Employee Stock Purchase Plan Tuition Reimbursement Disability Insurance Medical Insurance Vision Insurance Employee Discounts Health and Work/Life Balance Benefits Paid Time Off starting at 160 hours annually for employees in their first year of service. Ten (10) paid holidays per year (typically mirroring the New York Stock Exchange (NYSE) holidays). Be Well Company holistic wellness program, which includes Wellness Coaching and Reward Dollars Parental Leave fifteen (15) days of paid parental leave per calendar year to eligible employees with at least one year of service at the time of birth, placement of an adopted child, or placement of a foster care child. Adoption Assistance Employee Assistance Program Back-Up Care Program PTO for Volunteer Hours Employee Matching Gifts Program Employee Resource Groups Inclusion and Diversity Programs Employee Recognition Program Referral Bonus Programs Inclusion & Diversity We believe our commitment to diversity and inclusion creates a work environment filled with exceptional individuals. We're thrilled to have been recognized for our efforts through the Human Rights Campaign Corporate Equality Index, Dave Thomas Adoption Friendly Advocate, and several Seramount lists, including the Inclusion Index, 100 Best Companies for Working Parents, Best Companies for Dads, and Top 75 Companies for Executive Women. To foster a culture of inclusivity throughout our workforce, workplace, and marketplace, Transamerica offers a wide range of diversity and inclusion programs. This includes our company-sponsored, employee-driven Employee Resource Groups (ERGs), which are formed around a shared interest or a common characteristic of diversity. ERGs are open to all employees. They provide a supportive environment to help us better appreciate our similarities and differences and understand how they benefit us all. Giving Back We believe our responsibilities extend beyond our corporate walls. That's why we created the Aegon Transamerica Foundation in 1994. Through a mix of financial grants and the volunteer efforts of our employees, the foundation supports nonprofit organizations focused on the things that matter most to our people in the communities where we live and work. Transamerica's Parent Company Aegon acquired the Transamerica business in 1999. Since its start in 1844, Aegon has grown into an international company serving more than 23.9 million people across the globe. It offers investment, protection, and retirement solutions, always with a clear purpose: Helping people live their best lives. As a leading global investor and employer, the company seeks to have a positive impact by addressing critical environmental and societal issues, with a focus on climate change and inclusion and diversity. #J-18808-Ljbffr

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