Claims Adjudicator The Claims Adjudicator will be responsible for providing customers and sales representatives with high quality, individualized support by processing death claims and service requests for Life and Annuity Insurance contracts. The Claims Adjudicator will effectively communicate and correspond with external and internal customers. You will conduct research and analysis to ensure successful outcomes when complexities arise. The Claims Adjudicator will deliver accurate and prompt resolution of any issues that arise, and effectively communicate necessary information to the customers, sales representatives or client by both verbal and written communication. Duties and Responsibilities:
Process death claims for Life and Annuity Insurance contracts. Review all information and documents received with the claim submission, validate all details, ensure accuracy and completeness of documents, perform rule based payout calculation, and identify outliers to enable accurate processing.
Review and verify information including nominee details, relationship, names, addresses, banking details, and other data when reviewing claim submissions.
Perform thorough due diligence and process transactions with an extremely high degree of accuracy.
Adhere to client specific guidelines, policies, US state & federal guidelines when facilitating claim processing.
Evaluate insurance policy coverage and calculate respective claim amount.
Keep track of policy records and perform data entry to maintain accurate client information.
Ability to spot fraudulent claims, handle exceptional situations, identify red flags, and perform calculations based on nominees shareholding patterns.
Answers incoming calls and completes outgoing calls as needed.
Accurately and timely completion of service requests related to contract level transactions, and providing confirmation of contract level information.
Researches and analyzes issues in order to ensure successful outcomes and or resolution.
Develops relationships with clients and customers by becoming a dedicated resource.
Ensures high quality and consistency to customers by processing and servicing.
Develops broad understanding of products, services, policies, procedures, regulations and laws for effective service delivery.
Qualifications:
High school diploma or equivalent required, college degree preferred.
Prior experience of working in a Life and Annuities insurance business.
1 year of claims processing experience that required focus on quality including attention to detail, accuracy, and accountability.
Strong PC and keyboarding skills and the ability to use Microsoft Office products and auxiliary equipment and software.
Demonstrated and effective oral, written and interpersonal communication skills.
Ability to work effectively with other internal teams and associates.
Incumbents must be able to work required overtime.
Work history which demonstrates personal growth and aptitude for advancement.
SE2, an Eldridge Industries business, is a leader in technology-driven third-party administration services for the U.S. life and annuity insurance industry. Come join a recognized leader in third-party administration and experience a global, fast paced, fun and rewarding work environment. We offer excellent career progression and competitive compensation and great benefits, including health/dental insurance, parental leave, profit sharing, 401(k), incentive/bonus opportunity and tuition reimbursement. Visit our website at www.SE2.com for more information. Apply by completing the online application on the careers section of our website. EOE.
Salary.com Estimation for Claims Adjudicator in Topeka, KS
$59,970 to $81,934
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