Responsible for processing life, disability, and waiver of premium claims. Provides timely and accurate assistance to policyholders, agents, and funeral homes regarding policy and claim statuses through various communication channels, including telephone, email, and fax.
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Process and pay claims in accordance with established guidelines, including verification of coverage, gathering required documentation, and calculating payable benefits such as death benefits, interest, dividends, and premium variances.
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Prepare correspondence and update claims systems for claims ready to process.
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Conduct thorough research into beneficiaries, medical records, legal documents, and other critical information necessary for claim decisions.
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Handle incontestable claims, including related correspondence, accounting entries, and file maintenance.
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Authorize claim payouts during the probationary period; higher amounts may be authorized based on performance.
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Process and file reinsurance claims as applicable.
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Monitor suspense accounts and maintain accurate records for year-end tax reporting.
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Cross-train with Claims Analysts to support team coverage and workload balance.
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Communicate effectively with customers via phone, written correspondence, and email to ensure smooth claim processing.
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Accurately record customer interactions, including inquiries, complaints, actions taken, and outcomes.
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Maintain up-to-date knowledge of company products and policies and know where to seek additional guidance.
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Participate in special projects and assignments as needed.
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Assist with incoming calls and workflow for various Claims functions during peak periods.
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Strong proficiency in Microsoft Office; ability to learn proprietary and other software quickly.
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Knowledge of company products or a demonstrated ability to learn quickly.
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High attention to detail and accuracy.
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Excellent written and verbal communication skills.
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Strong analytical, research, and problem-solving abilities.
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Ability to manage multiple tasks and meet deadlines under pressure.
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Strong organizational and prioritization skills.
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Ability to accept direction and collaborate effectively with supervisors.
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Capacity to work independently as well as within a team environment.
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Flexibility and adaptability to changes in procedures or organizational structure.
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Positive attitude with a strong willingness to learn and grow.