The mission of this job is to promptly analyze policy files to determine and pay correct policy death benefits and beneficiaries and to handle incoming calls related to the death benefits.
- Accountable for identifying, investigating, evaluating, obtaining and utilizing critical information required to accurately and objectively adjudicate claims.
- Verbally communicate and correspond with outside customers to convey claim filing requirements.
- Handles claim inquiries and processing on multiple product lines.
- Documents all calls clearly and concisely and completes follow-up work.
- Identify areas of potential risk for the company, including potential fraud.
- Analyze all incoming documents for appropriateness and completeness, and determine whether claim is payable. If so, calculate benefit amounts and serve as 1st approver for payments.
- Serves as the first step in resolving claims adjudication issues and in the call escalation process.
- May be responsible for incoming and outgoing calls to claimants, Power’s of Attorney, facilities and other person’s or entities involved in the adjudication of a claim.
- Ensure all tax information is correctly reported.
- Maintain claim file with proper level of documentation.
- Answer customer inquiries.
- Maintain claim inventories within departmental, contractual, and regulatory guidelines.
- Death claims processing for life and/or annuity contracts preferred
- Two-year college degree or equivalent experience in a financial institution operations department, customer service, or annuity product experience.
- Knowledgeable in life or annuity products and death claim processing
- Must have sharp attention to detail and ability to perform with high degree of accuracy.
- Strong analytical skills to review documents and reach sound decisions
- Proven oral and written communication skill set.
- Ability to:
- Meet multiple performance targets at or above benchmark levels; including, but not limited to: accuracy, call quality, timeliness, and productivity.
- Work harmoniously with peers within a small team environment to accomplish both personal and team performance goals.
- Work with customers in a professional and empathic manner
- Work overtime, as needed, to meet daily deadlines
- Work simultaneously with multiple computer systems
- Compute moderately difficult mathematical calculations
- Available for 8 hour shift between 8am to 8pm working hours; Work from home
