Claims Examiner- Individual Life Death Claims (experience required)
About The Position
The Individual Life Claims Examiner is responsible for helping our customers maintain a sense of security by independently and effectively managing an assigned caseload of claims, in a fair and ethical manner and within all requirements and service standards. The Individual Life Claims Associate is responsible for reviewing and processing Individual Life Death Claims, clearing outstanding accounting, clearing up eligibility issues, and performing adjustments. Level II Associates may train, mentor, and audit less experienced associates, and may work with escalating claim issues with minimal leadership consultation, including taking on escalated calls.
Requirements
- Minimum 3-5 years experience managing life death claims required
- Experience interpreting policy language
- Strong written and verbal communication skills
- Experience working with Microsoft Office applications
- High School Diploma or GED
Nice To Haves
- training experience helpful
- Bachelor's Degree preferred in Business Management, Operations Management, Statistics, or Insurance.
- LOMA
Responsibilities
- Reviewing and processing Individual Life Death Claims
- Clearing outstanding accounting
- Clearing up eligibility issues
- Performing adjustments
- Customer Experience and support
- Effectively, accurately and timely communicate/collaborate with internal and external customers in accordance customer service protocols.
- Independently investigate, collect, examine information to determine claim direction to make accurate, impartial claim determinations based on facts, policies, regulations, and department procedures, for claims including those of a complex nature.
- Appropriately and independently use problem solving measures and discretion to investigate claims by utilizing appropriate investigative tools.
- Correctly calculates and processes claim benefit payments due within authority level.
- Prepares quality communication to agents, policy owners, insureds, beneficiaries, policyholders, medical providers, or other customer and business relationship parties.
- Identify, understand, and appropriately refer matters to legal counsel or escalates claim issues with minimal leadership consultation.
- Performance and Service expectations
- Maintains or exceeds departmental deadlines, requirements, service, accuracy, timeliness, and performance standards. Completes correct accounting transactions and clearing according to departmental procedures.
- Process Improvement
- Demonstrate EWA and support of the OneAmerica Ways.
Benefits
- Medical & prescription, dental, vision insurance
- Health Savings Account & Flexible Spending Accounts
- Paid Time Off
- 10 weeks 100% paid parental leave (after completing 12 months of employment)
- 401(k) Plan with company match
- Pension Plan
- Company paid life & disability insurance
- Wellness Program & Company paid employee assistance program
- Clinic access subject to location (Indianapolis, Charlotte, Cincinnati)
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
High school or GED
