Life Claims Assistant - Onsite (Fremont, MI)

Western & Southern Financial Group • Fremont, MI

3d • Onsite

About The Position

The Life Claims Assistant evaluates Gerber Life Insurance claim information and determines appropriate actions to assess, clarify, and appraise claims in compliance with policy provisions, claim procedures, legal requirements, and professional ethics. The role reviews, analyzes, investigates, and authorizes life insurance claim payments within established authority guidelines. It may involve direct communication with policyholders, beneficiaries, hospitals, doctors, attorneys, and internal or external teams to resolve claim matters.

Requirements

• High school diploma required.
• At least 2 years of relevant experience in claims processing required.
• Advanced understanding of medical conditions and terminology.
• Ability to deal effectively with external customers, including using patience, tact, and diplomacy to diffuse emotionally charged issues.
• Ability to read, listen, and communicate effectively verbally and in writing, including preparing formal and informal correspondence.
• Good judgment and ability to investigate, analyze, and summarize detailed information accurately to describe claim issues.
• Organizational skills, including competence in organization, prioritization, and multitasking.
• Understanding of compliance with life insurance.
• Knowledge of life and health claims.
• Problem-solving skills.
• High level of candor, trust, and integrity.
• Ability to serve as a change agent and deliver results.
• Motivation and flexibility to work in a fast-growing, fast-paced environment.
• Advanced PC skills and solid knowledge of standard office software.
• May be required, upon hire, to complete training or educational courses toward designations such as ALHC/FLHC and ACS.
• Ability to remain stationary for long periods while working at a desk, on a computer or other standard office equipment, or in meetings.
• Ability to communicate verbally and exchange accurate information with customers and associates regularly.
• Visual acuity to read and interpret correspondence, procedures, reports, and forms; inspect small defects or parts and machinery; use measurement devices; and assess the accuracy, neatness, and thoroughness of work.
• Ability to prepare written correspondence, reports, and forms regularly using prescribed formats and appropriate punctuation, grammar, diction, and style.
• Ability to apply logical thinking to define problems, collect data, establish facts, and draw valid conclusions.
• Ability to perform substantial, continuous wrist, hand, and finger movements for computer work.
• Availability to work extended hours during peak workloads or special projects or events.

Responsibilities

• Review, analyze, investigate, and authorize payment of life insurance claims within authority guidelines.
• Evaluate claim information and decide appropriate actions to assess, clarify, and appraise claims in compliance with policy provisions, claim procedures, legal requirements, and professional ethics.
• Communicate with policyholders, beneficiaries, hospitals, doctors, attorneys, and other internal and external parties; plan and prepare communications using tact, persuasion, and negotiation to reach resolution.
• Provide technical and professional advice to team members to help meet department objectives.
• Identify trends and opportunities for efficiency and improvement.
• Provide guidance on general claim policy and specific claim problems, including claim validity and interpretation of policy contracts and terminology.
• Perform other duties as assigned and comply with all policies and standards.

What This Job Offers

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