Claims Associate I

Kansas City Life Insurance Company•Kansas City, MO

50d

About The Position

Claims Associate I Kansas City Life Insurance Company, a recognized leader in the insurance industry, is seeking an energetic, self-motivated individual to join our Claims department. The ideal candidate would meet the following requirements: QUALIFICATIONS/REQUIREMENTS: Bachelor of Arts or Sciences degree in a business-related field or equivalent work experience. At least 4 years of practical insurance claim experience. Ability to use resources effectively, exercise good judgment, make decisions, and apply knowledge and experience to related situations to allow many types of requests to be handled independently. Ability to professionally interact with business people of all levels and succinctly communicate information to internal and external customers. General understanding of corporate multiline products, procedures, and practices. Demonstrated knowledge of company administrative systems and software. Familiarity with PC and Windows applications, including the ability to learn new and complex computer system applications. Regular and reliable attendance and punctuality is an essential function of this position DUTIES/RESPONSIBILITIES: Analyze claims and determine their validity based on policy provisions, riders, waivers, operating procedures, and state regulations. Calculate benefits payable and interest due. Ensure claims are paid in a prompt and equitable manner or decline payment for losses that are not covered. Provide superior customer service to claimants or their representatives. Prepare tax forms, state notice forms, and state consent forms when applicable. Maintain working knowledge of adjudication and reporting responsibilities within department and provide assistance to other examiners to ensure claims are handled in a timely manner. Order investigations on suicide, homicide, and accidental death claims. Investigate abandoned property cases. Administer reinsurance reporting and communication and assure proper reconciliation. Determine from medical records received, approval or denial of contestable claims; request medical information from doctors and hospitals as needed. Upon receipt, review and determine whether benefits are applicable and pay or deny claims. Approve and request claim expense checks for outside investigations and attorney's fees. Continually expand knowledge of human anatomy, physiology, disease processes, and medical practices and procedures, and consult with Underwriting or Medical Director as needed. Continually expand knowledge of legal decisions, opinions, proper practices, and procedures, and consult with Legal department as needed. Alert to spot red flags for potential fraud instances. Kansas City Life Insurance Company offers a competitive salary and an excellent benefits package. If you meet the above requirements and wish to join Kansas City Life's Claims department, please send resume and salary requirements in confidence to: Kansas City Life Insurance Company ATTN: Human Resources Department 3520 Broadway P.O. Box 219139 Kansas City, MO 64121-9139 EOE/MFVH e-mail:[email protected] Print this job description Close this job description

Requirements

Bachelor of Arts or Sciences degree in a business-related field or equivalent work experience.
At least 4 years of practical insurance claim experience.
Ability to use resources effectively, exercise good judgment, make decisions, and apply knowledge and experience to related situations to allow many types of requests to be handled independently.
Ability to professionally interact with business people of all levels and succinctly communicate information to internal and external customers.
General understanding of corporate multiline products, procedures, and practices.
Demonstrated knowledge of company administrative systems and software.
Familiarity with PC and Windows applications, including the ability to learn new and complex computer system applications.
Regular and reliable attendance and punctuality is an essential function of this position

Responsibilities

Analyze claims and determine their validity based on policy provisions, riders, waivers, operating procedures, and state regulations.
Calculate benefits payable and interest due.
Ensure claims are paid in a prompt and equitable manner or decline payment for losses that are not covered.
Provide superior customer service to claimants or their representatives.
Prepare tax forms, state notice forms, and state consent forms when applicable.
Maintain working knowledge of adjudication and reporting responsibilities within department and provide assistance to other examiners to ensure claims are handled in a timely manner.
Order investigations on suicide, homicide, and accidental death claims.
Investigate abandoned property cases.
Administer reinsurance reporting and communication and assure proper reconciliation.
Determine from medical records received, approval or denial of contestable claims; request medical information from doctors and hospitals as needed.
Upon receipt, review and determine whether benefits are applicable and pay or deny claims.
Approve and request claim expense checks for outside investigations and attorney's fees.
Continually expand knowledge of human anatomy, physiology, disease processes, and medical practices and procedures, and consult with Underwriting or Medical Director as needed.
Continually expand knowledge of legal decisions, opinions, proper practices, and procedures, and consult with Legal department as needed.
Alert to spot red flags for potential fraud instances.