Claims Adjuster I - REMOTE from any US based location

Core responsibilities and deliverables

• Reviews policy provisions and medical facts, along with any other documentation as needed, to make an appropriate claim decision in accordance with statutory and company requirements.
• Calculates payment of benefits due and processes claims in the appropriate admin system.
• Communicates with beneficiaries, policyholders and/or agents to request additional documentation, or to advise them of procedures necessary to complete claim adjudication and to communicate claim decisions.
• Documents claim file of all actions taken.
• Makes recommendations for process improvements.
• Consults with other areas of the company as the work demands (i.e. Underwriting, SIU, PHS, Legal, etc.).

Requirements

• Bachelor’s degree (preferred) or equivalent to 8 years of work-related experience
• 3 years insurance industry or financial services customer service experience with 1 year claim experience preferred

Qualifications

• Ability to provide prompt and high-quality customer service to our policyholders, beneficiaries and agents
• Basic knowledge of claims administrative procedures
• Basic knowledge of insurance products
• Good critical thinking abilities
• Basic ability to prioritize
• Basic ability to multi-task and adapt to an ever-changing environment
• Good knowledge of Microsoft Word, Excel and Outlook
• Good ability to effectively communicate, both verbally and through written correspondence to our customer
• Good knowledge of medical terminology
• Good decision-making abilities
• Good interpersonal and organizational skills

Benefits

• Medical, Dental, and Vision insurance
• Performance-based bonus or sales incentive
• 401(k) retirement plan with company match
• Short-term & long-term disability insurance
• Paid time off and 10 corporate holidays
• Paid parental leave
• Company-paid life insurance
• Mental & Financial Well-Being Resources

Pay

Pay Range: $19.36 - $29.04 Hourly