Claim Analyst 2 - Specialty Products
About The Position
As a Claim Analyst 2 on our Specialty Product Team, you'll have the opportunity to review, analyze, and make appropriate and accurate decisions on Accident, Critical Illness, Health Screenings and Hospital Indemnity claims in accordance with the policy and state/federal laws and regulations. This is a fast-paced environment where everyday offers change all while assisting our customers who may be facing major changes in life. Here are a few examples of the kinds of things you'll do: Analyze and adjudicate Specialty Product claims after determining and obtaining all appropriate claim requirements. Analyze enrollment, medical, and vocational information to make effective and timely claim decisions. Maintain fully documented claim file providing a clear and understandable audit trail required for compliance and legal purposes. Identify and refer claims with recommendation for appropriate action to other resources (senior claims personnel, Medical, Law, etc). Communicate with claimants, employers, and medical providers regarding claim decisions, status, and all other aspects of the claim process in writing or verbally. Prepare claim payments based on appropriate interpretation and administration of multiple different contracts and contract provisions. Perform other job-related duties and special projects as required. Operating at the intersection of financial services and technology, Principal builds financial tools that help our customers live better lives. We take pride in being a purpose-led firm, motivated by our mission to make financial security accessible to all. Our mission, integrity, and customer focus have made us a trusted leader for more than 140 years!
Requirements
- 4+ years of claims or customer service experience or equivalent demonstrated through one or a combination of the following: work experience, training, military experience, education.
- Ability to maintain a high degree of accuracy and pay strict attention to detail.
- Must be able to work in a team environment.
- Good analytical, organizational, problem solving and decision-making skills.
- Ability to maintain confidentiality.
- Good verbal and written communication skills (must be able to communicate with individuals experiencing illnesses, financial losses, or deaths of loved ones as well as legal and/or medical professionals).
- Good math skills.
- Ability to maintain good public relations with customers (employers, employees).
Nice To Haves
- Medical and/or legal terminology and prior Life and Disability or Specialty Product claims experience preferred.
Responsibilities
- Analyze and adjudicate Specialty Product claims after determining and obtaining all appropriate claim requirements.
- Analyze enrollment, medical, and vocational information to make effective and timely claim decisions.
- Maintain fully documented claim file providing a clear and understandable audit trail required for compliance and legal purposes.
- Identify and refer claims with recommendation for appropriate action to other resources (senior claims personnel, Medical, Law, etc).
- Communicate with claimants, employers, and medical providers regarding claim decisions, status, and all other aspects of the claim process in writing or verbally.
- Prepare claim payments based on appropriate interpretation and administration of multiple different contracts and contract provisions.
- Perform other job-related duties and special projects as required.
Benefits
- Personal Time Off (PTO) is provided to hourly (non-exempt) employees and provides a set amount of accrued time earned each pay period. Employees can use their PTO for vacation, personal or short-term illness.
- Pension Eligible
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
Number of Employees
5,001-10,000 employees
