Lead Manager-Investigations

Location NORTH CAROLINA, United States
Experience level Experienced Hire
Job details sector Life & Savings Insurance
Apply before Permanent offer
Provide strategic and managerial direction to the Life Insurance Special Investigation Unit within the Claims Department. Oversee and direct all SIU claim handling/investigative responsibilities enterprise-wide, to include, claim investigation, negotiation and claim disposition of all Life Insurance. Ensure that all claim handling and investigations are timely and proper. Ensure industry and company service standards are maintained, refined and improved upon, consistent with internal and external requirements. Deliver prompt, professional service to business partners and consumers while meeting all national compliance and regulatory obligations. Train, develop and motivate staff to meet and exceed departmental and industry expectations. Ensure that workflows, processes and procedures receive periodic reviews to identify where improvements in the levels of efficiency and effectiveness can be realized through a combination of automated, manual or outsourced solutions. Process owner and team manager for Long Term Care, Living Benefits and Disability Premium waiver claims.  
•People Leader- Lead operation and staff to achieve optimum service and utilization of resources.
• Provide direction, coaching, set expectations and manage the performance of the team.
• Assist team members with strategic development of workflow, time management and organizational skills.
• Prepare and manage an annual Claim Office budget, establish and monitor expense control program.
• Represent the company as an expert witness in Claims lawsuits, including consulting/strategizing with AXA litigation attorneys and outside counsel, and serving in depositions. 
• Review and analyze potential life claim declinations while consulting with Corporate Legal as appropriate prior to resolution.
• Handle appeals, consumer complaints and Regulatory complaints.
• Develop and facilitate training and effectively collaborate with staff to develop fraud recognition and investigative expertise.
• Maintain membership and take an active role in anti-fraud organizations and act as a liaison with government agencies.
• Keep abreast of developing industry trends, new case law and legal requirements and incorporate information into claim handling practices and protocols.
• Partner effectively with internal and external resources including underwriting and legal departments, law enforcement, legal and medical professionals, vendors, and community groups.
• Provide annual training for Fraud Awareness and California Fair Claims Practices regulations.
• Review and analyze potential life claim declinations while consulting with Corporate Legal as appropriate prior to resolution.
 

Basic:

Bachelors Degree with 8-10 years of experience

 

Preferred:

Thorough knowledge of product features and transaction processing. Proven leadership skills; demonstrate ability to lead and motivate others to achieve results. • Demonstrate professional oral and written communication skills. Strong decision making skills. Strong conflict resolution and negotiation skills. Demonstrate the ability to interpret research and opinions and apply accurately to establish investigative action plans.


NOTE: AXA participates in the E-Verify program.
 
In addition to competitive compensation and an outstanding benefits package including 401 (k) and medical programs, we offer the opportunity for continued professional development in a congenial corporate environment.
 
AXA is committed to providing equal employment opportunities to our employees, applicants and candidates based on individual qualifications, without regard to race, color, religion, gender, gender identity and expression, age, national origin, mental or physical disabilities, sexual orientation, veteran status, genetic information or any other class protected by federal, state and local laws.

AXA is a leading financial protection company, committed to fostering and maintaining a diverse, multicultural and inclusive environment, and one of the nation’s premier providers of life insurance and annuity products. The organization was established in 1859 and we are committed now more than ever to helping clients meet financial goals in all stages of their lives. One of the hallmarks of our proud heritage is providing world-class customer service.

We're always looking for smart and talented people to help us develop new and innovative ways to expand our product portfolio, reach new customers and serve well the clients already a part of the AXA family.