Manager, Chief Claims Examiner

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Manager, Chief Claims Examiner US-MI-Livonia Job ID: 2026-2217
# of Openings: 1
Category: Claims
Livonia Overview

Why AAA Life   AAA Life is a respected and trusted American brand that has been focusing on Life Insurance and Annuity Products since 1969 .   At AAA Life we have over 1.8 million policies where we take pride in earning the trust of our policyholders who understand our promise to be there for them – and their families – when   we’re   needed most .   By joining the AAA Life team, you are joining a company that genuinely cares about helping each other, with a devotion to protect the lives of those around us .   We embrace a diverse,   equitable , inclusive culture where all associates can feel a sense of belonging and use their unique talents and perspective to influence, innovate, motivate, and thrive.    How   You’ll   Work   Work Solution: Hybrid   Relocation Eligibility: No Responsibilities

Position Responsibilities   Provide strategic and technical leadership for complex, contestable, appealed, escalated, and litigation-related life insurance claims.   Serve as the senior claims subject-matter expert, providing guidance on policy interpretation, investigations, beneficiary issues, underwriting and medical evidence, fraud indicators, and regulatory requirements.   Exercise independent judgment within delegated authority and appropriately escalate matters involving significant legal, regulatory, financial, fraud, or reputational risk.   Lead technical strategy for appeals, disputes, complaints, litigation, and other elevated claims in partnership with Legal, Compliance, and key enterprise stakeholders.   Develop examiner technical capabilities through education, coaching, mentoring, case consultation, and consistent application of claims standards.   Analyze claims trends, appeals, litigation, complaints, and quality results to   identify   emerging risks, development needs, and process improvement opportunities.   Provide senior leadership with actionable insights and recommendations   regarding   claims trends, technical risk, emerging issues, and strategic opportunities.   Lead claims transformation and modernization efforts, including workflow redesign, automation, AI-assisted capabilities, digital tools, and adoption of new ways of working.   Partner   across Underwriting, Actuarial, Legal, Compliance, Risk, Investigations, Technology, and Reinsurance to resolve complex matters and strengthen risk management.   Oversee reinsurance reporting and technical claims resources while promoting fair,   timely ,   accurate , compliant, and customer-focused claim outcomes.    Position Success Criteria   Anticipates changes in claims complexity, regulation, customer expectations, technology, and workforce capability and translates them into actionable claims strategies.   Partners with Claims leadership to shape the future-state operating model, technical capability roadmap, and modernization priorities.   Identifies   opportunities to simplify, automate, and enhance claims processes while ensuring   appropriate human   judgment and controls for complex or sensitive matters.   Exercises delegated authority and sound judgment for complex, contestable, appealed, escalated, and other elevated claims.   Integrates policy provisions, claim facts, underwriting and medical evidence, legal/regulatory requirements, fraud indicators, and reinsurance considerations to resolve complex matters.   Provides technical direction and recommendations for claim disposition, investigation, litigation, settlement, escalation, and transformation initiatives.   Establishes   high standards   for technical quality, documentation, customer communication, professional conduct, and ethical decision-making.   Builds organizational claims   expertise   and bench strength through coaching, mentoring, case consultation, formal education, and continuous learning.   Uses   claims, quality, appeals, complaints, litigation, and operational data to   identify   trends, evaluate outcomes, and recommend improvements.   Demonstrates deep life insurance claims   expertise   and strong critical thinking, investigative judgment, communication, negotiation, and stakeholder management capabilities.   Qualifications



Basic Qualifications   A bachelor's   degree in business, insurance, finance, legal studies, risk management, or related field.  10+ years of progressive life insurance claims experience with substantial responsibility for complex claim adjudication.  5+ years of direct experience   adjudicating   or providing senior technical oversight of contestable life insurance claims.  5+ years of leadership experience, including   people   leadership, technical leadership, or significant claims operational leadership.   Demonstrated experience with appeals, complex coverage matters, litigation-related claims, investigations, and regulatory requirements.   Demonstrated experience educating, mentoring, or developing claims examiners and other claims professionals.    Preferred Qualifications   An advanced degree, such as JD, MBA, or related graduate degree.   FLMI, ALHC, ACS, ICA, or comparable insurance/ claims   designation.   Experience leading claims transformation, technology modernization, automation, analytics, or AI-enabled claims initiatives.   Experience with reinsurance claim management and complex vendor relationships.   Experience developing technical claims curriculum, case-based learning, or examiner   proficiency   programs.    While performing the duties of this job, the employee is   frequently   required to stand, walk, sit, use hands and fingers to handle, or feel, talk, hear, and concentrate .   Specific vision abilities required by this job include close vision, distance vision, depth perception, and ability to adjust focus.    This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements .   Reasonable accommodation will be   made   for otherwise qualified applicants as needed to enable them to fulfill these requirements.    We are committed to ensuring equal employment opportunities for all job applicants and employees. Employment decisions are based upon job-related reasons regardless of an applicant's race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability, marital status, genetic information, protected veteran status, or any other status protected by law.    AAA Life Insurance Company does not offer immigration sponsorship for this position. xzbcwsv This includes visa types such as H-1B, TN, and STEM OPT. Please do not apply if you currently   require   or may require employer-sponsored immigration support now or in the future.   PI95f8cfd4d6c9-38271-41550166