Western & Southern Financial Group

Life Claims Assistant - Gerber Life Insurance

Job Locations US-MI-FREMONT
ID
2020-14014
Category
Insurance Operations
Type
Full Time

Overview

Position Summary:

Evaluate claim information and deciding appropriate course of action to properly assess, clarify, and appraise the claim in compliance with policy provisions, claim procedures, legal requirements and professional ethics.

Responsibilities

Primary Responsibilities:

  • Review, analyze, investigate, and authorize payment of life insurance claims within authority guidelines.
  • Evaluate claim information and decide appropriate course of action to properly assess, clarify, and appraise the claim in compliance with policy provisions, claim procedures, legal requirements and professional ethics.
  • May communicate directly with policyholders, beneficiaries, hospitals, doctors, attorneys, and other internal and external areas. Contacts involve planning and preparation of the communications, require skills, tact, persuasion and negotiation to reach resolution.
  • Provide technical and professional advice to team members to help meet department objectives. Identify trends, efficiency and improvement opportunities.
  • Provide guidance regarding general claim policy, as well as specific claims problems involving the validity of claim, interpretation of policy contracts and terminology.
  • May be required to complete additional training/educational courses toward the attainment of designations such as ALHC/FLHC, and ACS.

Qualifications

REQUIREMENTS AND MINIMUM EDUCATION LEVEL:

 

  • High School diploma

EXPERIENCE:

 

  • 2 plus years of relevant experience in claims processing
  • Usually ranks at the level above a life claims examiner trainee
  • Advanced understanding of medical conditions and terminology

SKILLS:

  • Ability to deal effectively with external customers, some of whom will require high levels of patience, tact and diplomacy to diffuse emotionally charged issues
  • Ability to read, listen and communicate effectively both verbally and in writing in order to prepare formal and informal correspondence
  • Good judgment with proven ability to accurately investigating, analyzing, summarize detailed information in order to describe claim issues.
  • Organizational Skills
  • Customer & Consumer Excellence
  • Understanding of compliance with Life Insurance
  • Knowledge of Life/Health Claims
  • Problem Solving
  • Advanced level of PC skills
  • High level of candor, trust and integrity
  • Competence with organization, prioritization and multi-tasking
  • Change agent and have a proven track record for delivering results
  • Motivated with the flexibility necessary to operate is a fast growing and fast paced environment

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