Director - Claim Services

Director – Claim Services

All Boston Mutual employees who interact with our policyholders, our producers and our BML associates embrace the principles of our brand and service philosophy. We are all brand ambassadors. Both our words and our behaviors matter. We share a common service philosophy and pride ourselves in living the BML brand promises every day, one interaction at a time. The following statements represent what Boston Mutual stands for – it is what makes us different and better in the market we serve. We are for being a progressive life insurance company dedicated to offering financial peace of mind to working Americans and their families. We are for providing practical and affordable products designed for those we serve. We are for making it easy to secure a level of financial protection with a portfolio of products – beginning with life insurance – via enrollment and billing options at the workplace. We are for providing a personalized customer experience to our policyholders and producers. We are for acting in the best interests of our policyholders, producers, employees and the communities in which we live and serve – representing the goodness of mutuality in all we do. We do our best to: demonstrate a desire to assist, listen to understand and respond empathetically, explain things in a manner that is easy to understand, be knowledgeable students of our business, take full ownership to resolve questions and issues, be professional, polite and courteous, leave our customers and associates better than where we found them.

The Director – Claim Services plays a pivotal role within Boston Mutual, responsible for managing and overseeing of all aspects of the Claims Service team for Life and Accident Claims. This includes setting strategic direction, managing claims operations and ensuring regulatory compliance and an exceptional customer experience. This position reports directly to the Executive Vice President of Customer Experience. This role will also manage our external claims partners.

Claim Processing

• Directs and oversees the handling of all insurance claims.
• Ensure timely and accurate claim processing.
• Implements processes and procedures for all aspects of claims.
• Address and resolve complex customer issues and escalations.
• Consults with Legal and other experts to direct investigations and resolve complex and litigated claims.

Financial Management

• Develops and implements claims department policies, procedures, budgets and goals in alignment with the corporate strategy.
• Monitor claim processing and ensure accurate financial reporting.
• Work with finance teams to reconcile accounts and manage cash flow related to Claims payments.
• Implement and oversee claim payment plans and structures.
• Identify emerging issues and trends in claims that may impact company practices and processes.

Compliance and Risk Management

• Ensure all Claim processing activities comply with regulatory requirements and company policies.
• Stay informed about changes in regulations affecting Claim services.
• Develop and implement risk management strategies to minimize financial and operational risks working closely with Underwriting and Legal to teams.

Reporting and Analytics

• Develop and monitor key performance indicators (KPIs) related to Claim services.
• Prepare regular reports on Claim stats, reconciliations, and financial performance.
• Analyze data to identify trends, opportunities for improvement, and areas of concern.

Team Management

• Manage the overall performance of the entire Claim Services Team.
• Conduct performance reviews, quality assessments, and individual coaching meetings to support team member growth and development.
• Encourage collaboration among the leadership team within the Customer Experience department to support cross-team strategies, problem solving and workflow efficiency.
• Foster a positive employee culture; including coaching and motivating employees to perform at their best.
• Provide guidance and support to team members in handling complex cases through effective deployment of the Lead staff position.
• Monitor and adjust staffing and work assignments, including scheduling, time and attendance, in order to meet business needs.
• Collaborate closely with the Lead positions to develop and improve/maintain team efficiency, quality and training.
• Participate in the budget process and perform periodic analysis of staffing needs as required.
• Develop, monitor and provide regular reports reflecting results compared against departmental KPIs.
• Lead the documentation of procedures, identifying areas for improvement and fostering knowledge sharing within the team.
• Resolve escalated issues by effectively interacting with internal and external Customers.
• Supporting, developing and executing the company's strategic business plans.
• Represent the team in special projects and meetings as required.

Qualifications

• Education: College degree (Business Administration, Accounting) preferred; 7+ years' experience.
• Experience: Minimum of 7 years of equivalent business experience required. 5+ years of leadership experience required. The experience should ideally include progressively responsible roles with increasing levels of leadership and management responsibilities. Direct experience in team management, case handling, process improvement, and customer retention strategies is highly valued.
• Knowledge: Extensive knowledge in Insurance contracts, guidelines, practices and procedures. Excellent interpersonal skills and the ability to effectively build and extend relationships. Demonstrated proactive approaches to problem-solving with a strong decision-making capacity; demonstrated ability to take initiative with a "can do" attitude. Strong organizational skills that reflect ability to perform and prioritize multiple tasks seamlessly with excellent attention to context, substance and detail. Excellent written/verbal communication skills. Shows initiative with the ability to create and implement changes that will improve workflow. Working knowledge of Boston Mutual insurance products as well as administrative systems and process preferred. Exceptional skills using MS Office.
• Certifications/Licensures: LOMA or other insurance designation preferred.

Other Information

• Hybrid Work Model At our Canton location, employees will be on site Monday - Thursday. At our Omaha location, employees will be on site 2 days per week.
• Boston Mutual is an equal opportunity employer, and does not discriminate on the basis of race, color, age, religious creed, national origin, ancestry, sex, sexual orientation, gender identity, genetic information, disability, military service, veteran status, family status, pregnancy, or any other characteristic protected by federal or state laws. Boston Mutual is a drug-free workplace.