Claim Analyst 2

Principal Financial Group • Des Moines, IA

1d • Hybrid

About The Position

As a Claim Analyst 2, you'll have the opportunity to review, analyze, and make appropriate and accurate decisions on Critical Illness, Accident, and Hospital Indemnity claims in accordance with the policy and state/federal laws and regulations. This is a fast-paced environment where every day offers change all while assisting our customers who may be facing major changes in life.
Analyze and adjudicate 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 recommendations 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.

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/or prior Specialty Product claims experience preferred.

Responsibilities

• Analyze and adjudicate 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 recommendations 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed