Claims Lead

This Claims Lead will be responsible for overseeing and managing the daily operations of the claims team. This role involves ensuring efficient processing of claims, maintaining high standards of customer service, and guiding team members to achieve performance targets. The Claim Lead acts as a liaison between the claims team, other departments, and external stakeholders, ensuring compliance with company policies and regulatory requirements.

Position Responsibilities:

• Oversee the performance of the Claims Evaluation team and ensure that target metrics and service levels are met.
• Oversee the accurate and timely processing of claims, ensuring compliance with internal procedures and external regulations.
• Conduct regular individual and group discussions to communicate goals, changes in processes, and updates on company policies.
• Conduct periodic performance reviews and identify opportunities for improvement and professional development
• Ensure that the claims manual is regularly updated to reflect changes to the process and policies
• Implement quality control measures to ensure accuracy and completeness of claims documentation.
• Act as an escalation point for complex claims or customer service issues.
• Review and authorize high-value or complex claims.
• Participate in and contribute to product development as required, ensuring that the claim process is adequate and ready to support clients when the product goes live.
• Participate in digital initiatives and ensure that claims requirements are clearly and completely identified.
• Engage with distributors to identify pain points and areas for improvement.
• Prepare and present regular reports on claims processing metrics, team performance, and other key indicators.
• Analyze trends in claims data to identify potential risks or areas for improvement.
• Collaborate with management and other stakeholders to develop strategies for optimizing claims operations.

Required Qualifications:

• At least 10 years experience in life and health claims with at least 2 years in a supervisory or leadership role.
• A graduate of any four-year course, a medical or legal course would be an advantage
• Industry certifications (FLMI, etc.) is a plus
• Knowledge in MS Office applications
• Able to communicate clearly and effectively with peers and higher management
• Able to assess complex life and health claims
• Can decide on complex medical claims based on information gathered, product provisions and applicable insurance laws
• Able to clearly explain the rationale behind claim decisions
• Can identify and recommend improvements to systems and processes

When you join our team:

• We’ll empower you to learn and grow the career you want.

• We’ll recognize and support you in a flexible environment where well-being and inclusion are more than just words.

• As part of our global team, we’ll support you in shaping the future you want to see.

About Manulife and John Hancock

Manulife Financial Corporation is a leading international financial services provider, helping people make their decisions easier and lives better. To learn more about us, visit https://www.manulife.com/en/about/our-story.html.

Manulife is an Equal Opportunity Employer

At Manulife/John Hancock, we embrace our diversity. We strive to attract, develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment, retention, advancement and compensation, and we administer all of our practices and programs without discrimination on the basis of race, ancestry, place of origin, colour, ethnic origin, citizenship, religion or religious beliefs, creed, sex (including pregnancy and pregnancy-related conditions), sexual orientation, genetic characteristics, veteran status, gender identity, gender expression, age, marital status, family status, disability, or any other ground protected by applicable law.

It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process, contact [email protected].