Senior Claims Administrator

November 13

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EMC Insurance Companies

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1001 - 5000 employees

Founded 1911

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