Intermediate Claims Examiner

Transamerica•Cedar Rapids, IA

4d•$42,000 - $48,000•Remote

About The Position

The Intermediate Claims Examiner evaluates and analyzes documentation for claim payments or denials according to policy and certificate provisions and state regulations, within moderate authority limits. Under general supervision, the examiner reviews claim information, determines how to proceed and how to obtain additional information, documents correspondence and conversations, and communicates with claimants and other parties. The role also works with internal departments and specialists on contested claims, monitors for potential fraud, and maintains regulatory compliance. The position is described as a remote call center environment. The salary generally ranges from $42,000 to $48,000, and the position is typically eligible for an annual bonus at the company’s discretion. Applicants must be authorized to work for any employer in the United States; visa sponsorship is not available.

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 information and documentation received to determine how to proceed with a claim review 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 respond as appropriate, including engaging the Fraud team or conducting additional research.
Maintain compliance with regulations.

Benefits

Annual bonus eligibility based on the Company Bonus Plan and individual performance, at company discretion.
Comprehensive benefits package for eligible employees.
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.
Holistic wellness program, including wellness coaching and reward dollars.
Paid parental leave 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.