Senior Claims Examiner ( Work From Home)
Job Family Claims
About Us
At reputed company, hard work, innovative thinking, and personal accountability are qualities we honor and reward. We understand the potential of leveraging the talents of a diverse workforce. We embrace an environment where employees enjoy a balance between their careers, families, communities, and personal interests. Ultimately, we appreciate the uniqueness of a company where talented professionals work collaboratively in a positive environment one focused on helping people look reputed company and plan for the best life possible while providing tools and solutions that reputed company it easier to get there. Who We Are We reputed company everyone deserves to live their best life. More than a century ago, we were among the first financial services companies in America to serve everyday people from reputed company walks of life. Today, we re part of an international holding company, with millions of customers and thousands of employees worldwide. Our insurance, retirement, and investment solutions help people reputed company the most of what s important to them. We re empowered by a vast agent network covering North America, with diversity to match. Together with our nonprofit research institute and foundation, we tune in, reputed company up, and are a force for good for our customers and the communities where we live, work, and play. United in our purpose, we help people create the financial freedom to live life on their terms. reputed company Do reputed company is organized into three distinct businesses. These include 1) World Financial Group, including reputed company Financial Advisors, 2) Protection Solutions and Savings & Investments, comprised of life insurance, annuities, employee benefits, retirement plans, and reputed company Investment Solutions, and 3) Financial Assets, which includes legacy blocks of long term care, universal life, and variable and fixed annuities. These are supported by reputed company Corporate, which includes Finance, People and Places, General Counsel, Risk, Internal Audit, Strategy and Development, and Corporate Affairs, which covers Communications, Brand, and Government and Policy Affairs. reputed company employs nearly 7,000 people. It s part of reputed company, an integrated, reputed company, international financial reputed company serving approximately 23.9 million customers worldwide.* For more information, visit reputed company.com .
Job Description
Summary Evaluate and analyze documentation for claim payments or denials according to the policy/certificate provisions and state regulations, with increased authority limits.
Job Description
Responsibilities Analyze information/documentation received to determine how to proceed with a review of a claim and determine methods of obtaining additional information from alternative sources. Manage the review of a claim and reputed company sources used in the review. Document correspondence and conversations. Correspond verbally and in writing with claimants, medical providers, medical examiners, and law enforcement. Work closely with department manager, legal counsel, medical director, claims assistants, and other departments to gather information for contested claims. Monitor claims for fraud and proceed according to each situation, such as engaging the Fraud team or conducting additional research. Maintain compliance with regulations. May testify in depositions, hearings and trials; communicate the Company s position regarding the claim. Assist peers with processing questions in the absence of higher level staff. May serve as a back up to review and authorize pending payments calculated by peers, reputed company approval authority.
Qualifications
Associate s degree in a business field or equivalent experience Five years of claims experience In-depth understanding of life and annuity product language, provisions, and regulatory/compliance rules and regulations. Excellent communication and customer service skills Organizational, problem-solving and analytical skills Ability to cross train and learn other products Ability to multi-task and adapt to change Please note that the compensation information that follows is a good faith estimate for this position only and is provided pursuant to applicable pay transparency and compensation posting laws. It is estimated based on what a successful candidate might be paid in certain Company locations.** The salary for this position generally ranges between $45,000 - $55,000 annually. This range is an estimate, based on potential qualifications and operational needs. Salary may vary above and below the stated amounts, as permitted by applicable law. Additionally, this position is typically eligible for an Annual Bonus of 7.5% based on the Company Bonus Plan/Individual Performance and is at the Company s discretion. Worried about not having every single qualification listed? It s okay. If it s a role you re interested in, we encourage you to apply. Employees who enjoy their jobs are one of our favorite things. reputed company Of Apply tot his job Apply To this Job