We are looking for a Sr. Claims Specialist in our Syracuse office.
Salary Range: $38,777 (min) $49,713 (mid) $60,651 (max)
- Essential Duties and Responsibilities
- Utilize various administration/claim systems and policy files to verify benefit information, obtain calculations and verify final payments.
- Investigate, make final claim determination and process final settlement on contestable claims. Make decisions based upon review of medical records, autopsy and toxicology reports, and information developed through MVR reports and criminal background checks as well as underwriting opinion.
- Have an in-depth knowledge and understanding of our products and the claims administration thereof.
- Responds to telephone and written correspondence regarding claims. Includes inquiry calls, providing updates, status on requirements, payment information, etc.
- Prepare more complex letters to beneficiaries, agents, reinsurers, and attorneys as needed.
- Assist with the processing and claim determination of waiver of premium claims based upon review of medical information and policy provisions on an as needed basis.
- Routinely assist with the payment of non-contestable claims within specified limits in compliance with state regulations. (No processing limit)
- Approve claim payments within specified limits. (Face amounts up to $25,000.00)
- Critical Qualifications
- Associate's degree (A. A.) or equivalent from two-year College or technical school; or three years life insurance experience and/or training; or equivalent combination of education and experience.
- Minimum 1 year of disability and/or contestable life claims experience.
- LOMA courses 280, 290, 311 and 2 ICA courses required within 3 years.
- Desire and ability to handle more complex claims with time and experience.
- Ability to read and interpret documents such as policy contracts, rider coverages, medical records and procedure manuals.
- Strong written and verbal communication skills.
- Proficient PC skills with the ability to learn and use multiple systems.
- Analytic with demonstrated critical-thinking skills.
Preferred Qualifications: Prior Disability Claims or Contestable
Sun, Jan 24, 2021