Technical Claims Consultant

Reinsurance Group of America•Chesterfield, MO

5d•$89,310 - $134,870•Remote

About The Position

Provides technical claims expertise to RGA Re claims associates and clients. Conducts internal claims audits to evaluate the quality of the claims reviews. Identifies process improvements and needs for training. Performs external client audits to verify accuracy of claims adjudication practices and to ensure compliance with the terms of the treaty(ies). Develops relationships with client companies and RGA Re associates to ensure desired changes in practice are obtained. Reviews and approves the liability on large, complex claims. Provides technical expertise on disputed claims. Represents RGA Re in various claims industry activities. May manage senior claims staff.

Requirements

Bachelor’s Degree in Arts/Sciences (BA/BS) or equivalent related experience Required
8+ Years individual life claims experience and 5+ years in supervisory or managerial role Required
Intermediate Microsoft Word and Microsoft Excel Skills Required
Basic Microsoft Outlook Skills Required
Intermediate SQL Skills Required
Experience in conducting and summarizing audits Required
Demonstrated expertise in the technical considerations associated with life claims investigations, adjudications and litigation. Required
Demonstrated understanding of the financial reporting implications of the life/health claims process. Required
Competent ability to comprehend and interpret insurance and contract documents. Required
Ability to multi-task and meet tight deadlines Required
Advanced written and oral communication skills and organizational skills. Ability to share and impart knowledge. Required

Nice To Haves

Ability to resolve conflict Preferred
Ability to improve processes and add value Preferred
Advanced Query Skills Preferred

Responsibilities

Develops and implements processes which allows RGA Re to identify and resolve unfavorable trends in ceding company claims handling.
Establishes and implements an internal and external process for effective customer claims evaluations and feedback.
Represents RGA Re at industry meetings (presenter, committee member) and exercises influence, as appropriate, with customers.
Develops positive relationships with customers and encourages their overall customer practice to the advantage of RGA Re.
Keeps up-to-date with changes in claims adjudication for direct insurance writers. Maintains an awareness of vendors to ensure quality and service. Acts as a resource to customers and other RGA Re associates to assure knowledge transfer.
Participates in the identification of service opportunities that will encourage enhanced client claim handling.
Acts in a consulting role with clients and RGA Re associates on large and complex claims.
Works with all departments in the Operations division and other departments within RGA Re to identify and resolve problems/issues.
Recommends and participates in the development and implementation of process improvements that may extend beyond area of oversight and with the approval of Operations leadership.
Collaborates with other members of the US Ops Management team to implement and manage to goals/plans/budgets that align with division and company objectives.