Claims Representative I

Legal & General America•Frederick, MD

2d•$48,500 - $55,000•Hybrid

About The Position

At Legal & General America, we aim to make a positive difference in the lives of our customers, partners, colleagues, and the communities in which they live. As a recognized market leader of term life insurance, we’re working to transform our business through innovation and technology to provide products and solutions that help American families secure their financial futures. We are a future-focused company, passionate about what we do and how we do it. This means working with pace and energy to reach our goals, and challenging ourselves to achieve more. We strive to create a unique environment where balance between work and life is possible. Our employees' passion, dedication and hard work, as well as our career development opportunities, benefits, and employee activities contribute to our positive workplace culture. The Claims Representative is responsible for the set up, research, review and processing of non-contestable claims and live rescissions within established productivity and quality standards. Complete all other claims related tasks to meet or exceed pre-defined productivity and quality standards. Complete other administrative duties and projects as directed by management.

Requirements

High School diploma or equivalent
1-2 years of experience in life or health claims or customer service/administrative position preferred.
Typing 35 WPM
Proficiency in spreadsheet and word processing software
Detail oriented
Strong organization skills
Outstanding verbal and written communication skills
Superior customer service skills
Good problem solving and negotiation skills
Product knowledge and ability to understand basic contract language
Good analytical skills
Ability to work in a fast-paced environment
Knowledge of Microsoft Office (Word and Excel)

Nice To Haves

Some college preferred

Responsibilities

Review and process live rescissions within established productivity and quality standards.
Prepare written communication to insureds regarding rescission of in force life insurance policies.
Set up, research, review and process non-contestable claims within established productivity and quality standards.
Review company records to confirm insurance coverage.
Review all beneficiary and title changes and collateral assignments for correctness and generate appropriate correspondence in accordance with state insurance regulations requesting appropriate claim requirements.
Open claims files according to departmental procedure.
Notify reinsurers of newly filed death claims.
Evaluate documentation submitted for processing of claim and confirm eligibility for payment utilizing knowledge of estates, trusts, minor beneficiary requirements, divorce statutes and other regulatory requirements. If documentation is insufficient, request correct or additional requirements needed in order to give the claim further consideration.
Correspond and communicate with claimants, attorneys, agents, reinsurers and other company departmental staff to discuss and/or resolve matters relevant to effective claims administration, including competing claim issues.
Review progress and status of pending claims with management and discuss problems and suggested solutions.
Follow up on all pending non-contestable claims within established regulatory requirements.
Follow established escheat procedures on pending claims review and run public records database searches as needed.
Process claim on administrative systems using the appropriate Post Mortem Interest statutes, dividend calculations, and contract provisions to reflect settlement or payment of claim to the appropriate party.
Send disbursement correspondence and document file reflecting interest and payment amount.
Document all activity to support claim file
Answer phones and respond to correspondence pertaining to the initial notification of death.
Keep abreast of “red flags” for fraud and identify potential issues to prevent payment of fraudulent claims including foreign death requirements.
Complete form 712’s as needed.
As required, bill reinsurer for their share of the liability and update appropriate system. Communicate with reinsurers as needed on problem cases.
Keep abreast of claims related regulatory requirements.
Operate in a team environment and support other team members to enhance overall productivity.
Complete all other projects and tasks assigned by management.