Claims Examiner III, Accident & Health

AIG • Lenexa, KS

5d • Onsite

About The Position

At AIG, we are reimagining the way we help customers to manage risk. Join us as a Claims Examiner III, Accident & Health to play your part in that transformation. It’s an opportunity to grow your skills and experience as a valued member of the team. Make your mark in Claims Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we take pride in delivering responsive, fair and professional service with empathy and efficiency. How you will create an impact This position of the Claims Examiner III Accident and Health is responsible for handling various types of personal accident and health claims including accident death and dismemberment claims, accident and sickness claims, critical illness claims, hospital cash claims, out of country medical and business-related travel claims. The candidate for this position must operate in accordance and within all operational/Best Practices guidelines. This would include determining coverage, drafting denial letters, attendance at mediation / settlement conference and instructing attorneys in the negotiation and settlement of claims. The Claims Examiner III Accident and Health will be responsible to handle all aspects of claim resolution for assigned claims while providing world class service to external and internal customers.

Requirements

• Insurance claims experience of at least 3+ year(s) with exposure to Accident and Health claims preferred, and/or, sickness and accident benefits type injury claims or any related experience.
• College/University or equivalent industry experience.
• State Licensing required, or will need to be obtained
• Proficient computer skills to navigate paperless claim file system.
• Excellent written, verbal communication, and interpersonal skills.
• Ability to manage workload effectively and efficiently/ability to prioritize is essential.
• Willingness to work closely with colleagues on skill development.
• Ability to read and interpret insurance policies.
• A highly organized individual with ability to work in a high pace environment

Responsibilities

• Confirm coverage of claims (AD&D, accident and sickness claims, critical illness, hospital cash claims, out of country medical and business-related travel claims) by reviewing policies and documents submitted in support of claims.
• Analyze coverage and communicate coverage position.
• Conduct, coordinate, and direct investigation into loss facts.
• Determine eligibility of claims and amounts owed under the terms of the contract.
• Recognize and pursue subrogation where warranted.
• Recognize and make appropriate Risk and Fraud referrals.
• Operate within our best practices guidelines, including timely reserve review, notes, payment requests, electronic diary.
• Other duties as assigned.

Benefits

• Compensation for this position includes base salary and eligibility for a bonus in accordance with the terms of the applicable incentive plan.
• In addition, we’re proud to offer a range of competitive benefits, a summary of which can be viewed here: US Benefits
• At AIG, our people are our greatest asset. We know how important it is to protect and invest in what’s most important to you. That is why we created our Total Rewards Program, a comprehensive benefits package that extends beyond time spent at work to offer benefits focused on your health, wellbeing and financial security—as well as your professional development—to bring peace of mind to you and your family.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees