Perform all activities associated with the settlement of claims on life insurance policies and riders. Determine correct beneficiary(ies) and order claim requirements. Review documents, interact with clients, advisors and outside vendors. Determine claim benefit and process payments to the benefiary(ies)
Adjudicate timely claim payments by determining the type and amount of the claim, verifying in-force status of the insurance policy, confirming policy provisions and determining the appropriate payee of the benefits. Handle complex beneficiary designations, foreign death claim investigations along with complex issues related to payment of claims to trusts, estates, minor beneficiaries etc.
Thoroughly and accurately document the claim files.
Manage client/Advisor relationships by providing and updating the client on status of information needed. Communicate regarding status and collaborate with internal business partners to perform process hand-off's during the life cycle of the claim.
Understand and interpret life insurance contracts, regulatory requirements, Fair Claim Handling, and legal risks related to insurance claims adjudication. Identify claim risk and red flags, mitigating such risk during adjudication of the claim.
Provide secondary review and approval for peers within authority levels. Identify issues and provide feedback to pro actively address issues. Participate as a SME resource for improvement initiatives.
Associate degree or equivalent # of years of work experience handling life claims
Life Claims Experience- Minimum 3-5 years
Ability to draft written correspondence that is professional and clear
Attention to detail with strong documentation skills during the entire claims process
Understanding of life insurance contract as they relate to claim benefits
Critical Thinking skills: gather information, apply reasoning, and make sound experience based on analysis, experience and judgment
Excellent organizational skills and effectively prioritize tasks
Proven written and verbal communication skills
Thorough documentation skills
Experience with Microsoft applications: Word, Excel, Outlook