Senior Claims Administrator
November 13
Description
• Analyzes and investigates claims to ensure compliance and timely payment of benefits • Responds to agents and policyholders regarding pending claims and appeals • Processes complex beneficiary and ownership changes and approves eligibility of waivers for life and disability income policies • Collaborates with peers and management to ensure consistent interpretations of policies and claim payment methods • Obtains reports, medical records, eligibility, and/or additional information required to investigate and process claims • Prepares filings for all life reinsurance benefits and tracks status of payments • Ensures that claims are in compliance with state and federal mandates and reviews for red flags associated with potentially fraudulent claims • Trains new claims team members and assists current claims staff with processing issues
Requirements
• Bachelor’s degree, preferably in insurance or business administration, or equivalent relevant experience • Three years of experience in life, annuity and/or health claims, or related experience • LOMA and/or International Claims Association (ICA) certifications preferred • Strong knowledge of life, annuity, WOP, contestable, and critical/chronic claims processing including federal and state regulations and tax legalities • Good knowledge of medical and legal terminology • Strong computer knowledge of Microsoft Suite, Outlook, Access, and insurance administration systems • Excellent verbal and written communication skills • Strong math and analytical skills • Good investigative and problem-solving abilities • Excellent organizational and customer service skills • Ability to work in a fast-paced team environment
Benefits
• Outstanding benefits with life, medical, dental, vision and prescription drug coverage • Competitive paid time off plan and a full day of volunteer time off annually • Financial incentives, including a 401(k) plan match, pension plan, OneEMC bonus plan and recognition and anniversary awards • Professional development and growth opportunities, including tuition reimbursement • Wellness initiatives to improve team member well-being and reduce health insurance costs • Flexibility to dress for your day and opportunities for alternative work arrangements
Apply NowSimilar Jobs
November 13
Sinch
1001 - 5000
Provide world-class support at a growing tech company processing billions of messages.
🇺🇸 United States – Remote
💵 $18 - $21 / hour
💰 Post-IPO Secondary on 2022-09
⏰ Full Time
🟡 Mid-level
🟠 Senior
🖥️ Administration
November 12
GovInvest
11 - 50
Office Administrator for GovInvest, managing administrative tasks for government digital services.
November 12
Boston Medical Center (BMC)
5001 - 10000
RN Appeal Administrator for Boston Medical Center's denial and appeal processes.
November 12
WashU IT
501 - 1000
Coder position reviewing pediatric medical records for billing accuracy.
November 10
IQBG Inc
51 - 200
Experienced OpenText Administrator for IQ Business Group’s Enterprise Software Solutions.