Claims Adjudicator

National Guardian Life Insurance Company•Madison, WI

43d•Hybrid

About The Position

The Claims Adjudicator is responsible for processing claims, effectively communicating and corresponding with external and internal customers including policyholders, agents, funeral directors, and beneficiaries. Additional responsibilities include processing various types of claims and service requests along with providing phone support accurately within or exceeding existing service goals. In this role, work is performed under general supervision. The position requires the need to conduct additional research and to accurately document all findings as deemed appropriate.

Requirements

Intermediate knowledge of NGL and acquisition products and procedures
Intermediate communication skills--oral and written
General PC and office machine knowledge
Typing skills of at least 45 words per minute and 5500 keystrokes per hour alphanumeric
Knowledge of basic accounting skills
Ability to work in a team environment
Organized and detail oriented
Ability to quickly search the Internet and other databases
One year claims processing experience or equivalent business experience.

Nice To Haves

Two years customer service or insurance/financial experience preferred.
LOMA Level I Certificate
LOMA ACS
Wisconsin Preneed Certification

Responsibilities

Accurately adjudicate claims within stated service goals.
Follow established written processing procedures
Verify proper forms are received according to state regulation
Accurately enter and process: Whole life, Term Life, Universal life & Interest sensitive, Acquisition Preneed, Final Expense, Preneed, Trust claims including Tru Trust, NGL Funeral Expense Trust, and NGL Estate Planning Trust, Preneed Texas including accurate reconciliation and file documentation verification, Annuities, Contestable claims including referring claims to Underwriting as needed, Rider claims including accidental death, child/family rider, and spouse rider.
Accurately calculate cost basis on basic annuity claims
Follow-up timely on all claims in writing within state regulated time frames
Provide phone support for all claims related calls and letter correspondence
Ability to effectively communicate, with empathy when appropriate, to our customers verbally, in writing, and via email
Ability to actively listen and appropriately respond to others
Provide phone support for claims related calls while maintaining team service goals
Contact agents, funeral homes beneficiaries, and other customers to obtain missing information when needed
Prepare proper correspondence for all steps in the claim process and as needed to respond to customer inquires
Ability and willingness to work with others in a team environment
Participate in group decision making, listening, and responding constructively to others
Offer help to teammates when the need arises
Manage and adjust personal time off, breaks, and lunches to insure sufficient team coverage
Help ensure that team standards and goals are maintained
Transfer knowledge from one process and apply it to another like process regarding common situations
Able to gather most needed data and petition input to help recognize the symptoms and root causes of distinct problems
Examine defined issues with ambiguous causes
Suggest alternative approaches that meet the needs or the organization, the situation, and those involved
Resolve difficulties and escalate issues with suggestions for additional inquiry
Accurately research insured status
Search databases to confirm Insured status
Update spreadsheets and document appropriately
Complete assigned projects, tasks, and/or milestones by agreed upon due dates including performing other related work as requested or required

Benefits

20 days of Paid Time Off growing to 25 days after 5 years
11 Paid Holidays (10 company holidays and 1 personal holiday of your choice)
Health care, dental and vision plans
Up to $1,500 (Family) or $1,000 (Single) annually towards a Health Savings Account
Annual bonus based on company performance
Paid Parental Leave
401(k) match up to 9%
Paid Sabbatical after 8 years
Paid Volunteer Time
Education Assistance Program
Employee Recognition Program