Posted: 8 months ago
Posted: 8 months ago
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Job Description
- Claims Background, Process Life Insurance Claim request with Insurance Regulations
- Reviewing & Indexing documents to determine type of request(s) and process them as per set guidelines
- Review & Investigating Claims
- Determines covered insurance losses by studying provisions of a policy or certificate.
- Establishes proof of loss by studying documentation and assembling additional information from outside sources
- Documents specific claims by completing and recording forms, reports, logs, and records.
- Resolves claims by approving or denying documentation, calculating benefits due, and determining compensation settlement.
- Ensures legal compliance by following company policies, procedures, and guidelines, as well as state and federal insurance regulations.
- Maintains quality customer service by following customer services practices and responding to customer inquiries
- Provides legal support by assembling documentation for settlement action.
- Maintains a good relationship with insurance departments.
- Protects operations by keeping claims information confidential.
- Processing transactions received through faxes, web submissions, mail, Contact Center requests, etc.
- Processing a wide range of non-financial transactions through good order review for incoming contract changes due to death claim or divorce transactions.
- Knowledge and proficiency of multiple mainframe systems necessary.
- Researching in automated work distributor for duplicate work items, routing, as necessary.
- Redirect documents to appropriate operational area as needed
- Contribute to individual quality and productivity goals by meeting processing targets focused on turnaround time expectations
- Promote a positive customer service mindset to surpass the expectations of customers through continuous improvement
- Identify and capitalize on best practices to ensure consistency and optimal performance in a team based environment
- Active participation in ongoing development of self
- Continue to build additional knowledge and understanding of the clients business
- Perform other duties as needed
Skills
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