Intermediate Claims Examiner

Transamerica•Cedar Rapids, IA

5d•$42,000 - $48,000•Remote

About The Position

Evaluate and analyze claim documentation to determine whether claims should be paid or denied, in accordance with policy and certificate provisions and state regulations. The role has moderate authority limits and operates under general supervision. It is performed in a remote call center environment. The examiner analyzes claim information and documentation, reviews claims and outside sources, determines how to proceed and how to obtain additional information, and communicates with claimants and other parties. The role also supports contested-claim investigations, monitors for potential fraud, and maintains regulatory compliance.

Requirements

Associate’s degree in a business field or equivalent experience.
Two years of claims experience.
Good understanding of life and annuity product language and provisions, and regulatory and compliance rules and regulations.
Excellent communication and customer service skills.
Organizational, problem-solving, and analytical skills.
Ability to cross-train and learn other products.
Ability to multitask and adapt to change.

Responsibilities

Analyze received information and documentation to determine how to proceed with claim reviews and how to obtain additional information from alternative sources.
Review claims and outside sources used in the review.
Document correspondence and conversations.
Communicate verbally and in writing with claimants, medical providers, medical examiners, and law enforcement.
Work with the department manager, legal counsel, medical director, claims assistants, and other departments to gather information for contested claims.
Monitor claims for fraud and take appropriate steps, such as engaging the Fraud team or conducting additional research.
Maintain compliance with regulations.

Benefits

Competitive pay
Annual bonus eligibility, subject to the Company Bonus Plan, individual performance, and company discretion
Pension plan
401(k) match
Employee stock purchase plan
Tuition reimbursement
Disability insurance
Medical insurance
Dental insurance
Vision insurance
Employee discounts
Career training and development opportunities
Paid time off starting at 160 hours annually for employees in their first year of service
Ten paid holidays per year
Wellness program with wellness coaching and reward dollars
Paid parental leave of 15 days per calendar year for eligible employees with at least one year of service
Adoption assistance
Employee assistance program
Back-up care program
Paid time off for volunteer hours
Employee matching gifts program
Employee resource groups
Inclusion and diversity programs
Employee recognition program
Referral bonus programs