Since 2000, Crum & Forster’s Accident & Health division (A&H) has offered a diverse portfolio of specialty insurance and reinsurance products nationwide. We place a strong focus on product development and creative distribution methods, along with excellent client service and support.

In addition to our robust domestic portfolio, which spans both special risk and medical solutions, A&H works on an international basis through various partnerships. Our global capabilities provide our partners with even broader flexibility in underwriting solutions.

The qualities and capabilities of A&H demonstrate our philosophy of building meaningful, long-term partnerships and our dedication to providing alternative strategies in an ever-changing insurance market.

The A&H MBU takes a full-spectrum approach to designing and servicing a robust slate of products tailored to needs in Employer Stop Loss, Excess Medical, Life, and Ancillary and Supplemental benefits. Our diversified business model includes program partnerships as well as direct sales in Employer Stop Loss. At year-end 2024, the MBU recorded $746M in gross premium written.

Information about the Role, Line of Business and Team:

The role of Stop Loss Claims Manager is a unique opportunity to work with a high quality team of leaders and benefit from the security and stability of a large organization while maintaining a nimble and responsive approach to business.  The successful candidate will work as part of a team and be responsible for evaluating claim eligibility, outlining claim exposure, processing payments to policyholders, and maintaining appropriate reporting to management.  This individual will interact internally with fellow team members, Underwriting and Support staff, and externally with the division’s business partners. The CFSL team has an objective to write and administer $2 billion in business in the next 5 years. 

What you will do:

• Review claim submissions for accuracy, completeness, and compliance with various Plan Documents, SPD, and Policies
• Align unit and divisional priorities with company objectives and motivate the team to achieve key goals
• Act as the primary liaison for both internal and external business partners on critical claims matters
• Train and support staff in establishing reserves
• Clearly and professionally communicate claim payment or denial decisions
• Identify and assist with complex claim or coverage issues, provide recommendations, and manage their resolution
• Assist with aggregate accommodation activities and aggregate claim submissions
• Enhance and refine internal and external claims procedures, recommending improvements to management
• Maintain thorough reporting and open communication with leadership regarding assigned responsibilities
• Lead and manage a team of Claims Examiners and provide the leadership necessary to maintain a motivated, productive and competent team through open communication and delegation of responsibilities and authority
• Be a team leader and builder who has an eye for talent with the ability to maximize resources and capability to deliver business results
• Drive performance excellence through goal-setting, quality feedback, and performance appraisals within the team (midyear and annual)
• Create a working environment where productivity can be sustained and accomplished, and where innovation and personal growth is encouraged and realized
• Drive and role model the A&H culture, values and C&F core competencies within their teams
• Provide mentorship and training to new claims staff, particularly Claims Examiner Trainees, setting them up for success
• Guide and direct team members in their personal and professional development
• Other duties as assigned

What YOU will bring to C&F:

• Strong ability to build relationships with stakeholders at all levels
• Commitment to delivering outstanding customer service and satisfaction
• Ability to identify, recommend, and implement process improvements to align with and achieve organizational goals
• Exceptional attention to detail and accuracy
• Capability to manage multiple priorities in a fast-paced environment
• Excellent written and verbal communication skills

Requirements:

• Associates or Bachelor’s degree from an accredited university preferred
• 8+ years’ claim experience required
• 2+ years of people management experience required
• Strong working knowledge of Microsoft Office suite with an aptitude to learn new programs (DY/ESL Office experience preferred)  

• Competitive compensation package
• Generous 401K employer match
• Employee Stock Purchase plan with employer matching
• Generous Paid Time Off
• Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family’s wellness, including your physical, mental and financial wellbeing
• A core C&F tenet is owning your career development, so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training to keep you progressing on your chosen path
• A dynamic, ambitious, fun and exciting work environment
• We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community

We value inclusivity and diversity. We are committed to equal employment opportunity and welcome everyone regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you require special accommodation, please let us know.

For California Residents Only:  Information collected and processed as part of your career profile and any job applications you choose to submit are subject to our privacy notices and policies, visit https://www.cfins.com/onlineprivacypolicy/ca/noticeatcollection/ for more information.

Crum & Forster is committed to ensuring a workplace free from discriminatory pay disparities and complying with applicable pay equity laws.  Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions. The annualized base pay for the advertised position, located in the specified area, ranges from a minimum of $67,900.00 to a maximum of $127,600.00. The actual compensation is determined by various factors, including but not limited to the market pay for the jobs at each level, the responsibilities and skills required for each job, and the employee’s contribution (performance) in that role. To be considered within market range, a salary is at or above the minimum of the range. You may also have the opportunity to participate in discretionary equity (stock) based compensation and/or performance-based variable pay programs.

#LI-BS1

#LI-REMOTE