Life Claims Assistant - Onsite

Western & Southern Financial Group • Fremont, MI

4d • Onsite

About The Position

Evaluates claim information and decides appropriate course of action to properly assess, clarify, and appraise the claim in compliance with policy provisions, claim procedures, legal requirements, and professional ethics. This role involves reviewing, analyzing, investigating, and authorizing payment of life insurance claims within authority guidelines. The assistant will communicate directly with policyholders, beneficiaries, hospitals, doctors, attorneys, and other internal and external parties, requiring tact, persuasion, and negotiation skills. Additionally, the role provides technical and professional advice to team members, identifies trends and improvement opportunities, and offers guidance on general claim policy and specific claim issues related to validity, contract interpretation, and terminology. The position also requires performing other duties as assigned and complying with all policies and standards.

Requirements

• High School Diploma
• 2-plus years of relevant experience in claims processing.
• Proven advanced understanding of medical conditions and terminology.
• Demonstrated ability to deal effectively with external customers, some of whom will require high levels of patience, tact and diplomacy to diffuse emotionally charged issues.
• Demonstrated ability to read, listen and communicate effectively both verbally and in writing in order to prepare formal and informal correspondence.
• Good judgment with proven ability to accurately investigate, analyze and summarize detailed information to describe claim issues.
• Demonstrated organizational skills.
• Proven understanding of compliance with life insurance.
• Proven knowledge of life/health claims.
• Proven problem-solving skills.
• Proven to have a high level of candor, trust and integrity.
• Demonstrated competence with organization, prioritization and multi-tasking.
• Proven to be a change agent and have proven track record for delivering results.
• Proven to be motivated with the flexibility necessary to operate in a fast-growing and fast-paced environment.
• Advanced PC skills.
• Solid knowledge of standard office software.
• May be required to complete training/educational courses toward the attainment of designations such as ALHC/FLHC, and ACS. Upon Hire - Required

Responsibilities

• Reviews, analyzes, investigates and authorizes payment of life insurance claims within authority guidelines.
• Evaluates claim information and decides appropriate course of action to properly assess, clarify and appraise the claim in compliance with policy provisions, claim procedures, legal requirements and professional ethics.
• May communicate directly with policyholders, beneficiaries, hospitals, doctors, attorneys, and other internal and external areas.
• Contacts involve planning and preparation of the communications, requiring skills, tact, persuasion and negotiation to reach resolution.
• Provides technical and professional advice to team members to help meet department objectives.
• Identifies trends, efficiency and improvement opportunities.
• Provides guidance regarding general claim policy, as well as specific claims problems involving the validity of claim, interpretation of policy contracts and terminology.
• Performs other duties as assigned.
• Complies with all policies and standards.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED