Senior Account Manager

Accountabilities
As a Senior Account Manager, you will act as a client-facing LTC claims expert, supporting strategic initiatives, claim reviews, audits, and operational improvements. You will leverage your industry knowledge to evaluate complex cases, provide recommendations, and strengthen claim management practices across client organizations. Serve as a senior advisor on Long-Term Care claims, providing expertise in claim adjudication, medical impairment assessment, and industry best practices. Manage and review complex, high-liability, high-dollar, and contestable claims requiring advanced clinical, contractual, legal, or administrative analysis. Evaluate claim management practices against applicable guidelines, policy provisions, contractual requirements, and industry standards. Assess potential risks, fraud indicators, liability concerns, and emerging issues while providing actionable recommendations to leadership. Lead and participate in external claim audits, including planning, file reviews, report preparation, findings discussions, and recommendation follow-up. Develop and deliver client training programs, educational materials, claim tools, and resources to improve operational consistency. Build and maintain strong client relationships by addressing claim-related questions, resolving issues, and supporting account management activities. Analyze claim trends, operational performance, and adjudication patterns to create business reports and improvement recommendations. Support strategic projects, process improvement initiatives, and the development of client-facing solutions. Represent the organization during client meetings, industry discussions, training sessions, and professional events. Travel as needed to support client engagements, audits, training activities, and industry meetings. Requirements The ideal candidate is a highly experienced LTC claims professional with strong analytical abilities, communication skills, and the confidence to advise clients and senior stakeholders. You should have a deep understanding of insurance claims operations and experience managing complex client-facing responsibilities. Bachelor’s degree in a relevant field. Industry-related certifications or designations such as ICA or LOMA are preferred. 8+ years of progressive experience in Long-Term Care claim adjudication. Demonstrated experience managing client-facing claim responsibilities, including consultation, issue resolution, relationship management, and presenting recommendations. Experience leading or participating in external claim audits and preparing detailed audit reports. Experience identifying training opportunities, developing educational materials, and supporting claim process improvements. Strong knowledge of direct insurance company claims operations and LTC claim management practices. Ability to analyze claim trends, prepare business reports, and translate findings into practical recommendations. Excellent written and verbal communication skills with the ability to engage technical and non-technical audiences. Strong problem-solving abilities with the creativity and judgment needed to improve processes and resolve complex challenges. Ability to work independently, manage priorities effectively, and collaborate with internal and external stakeholders. Benefits Fully remote position within the United States. Competitive base salary range of $125,000 to $140,000 for eligible locations, plus annual bonus opportunities. Comprehensive medical, dental, and vision insurance plans. Prescription drug coverage included with health insurance options. Life insurance, accidental death and dismemberment coverage, and disability benefits. Supplemental insurance options including accident, critical illness, and hospital indemnity plans. 401(k) retirement plan with up to 6% employer match. Generous paid time off starting at 24 days annually, with additional days for service milestones. Wellness programs, fitness reimbursement, and health-focused initiatives. Paid family care leave and volunteer time off opportunities. Tuition assistance and educational achievement incentives. Corporate charitable matching programs. Opportunity to work with global teams and contribute to meaningful industry innovation.

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