Claims Examiner - 0953

Company: Security Mutual Life Insurance
Location: Binghamton
Posted on: May 8, 2022

Job Description:

As an experienced life insurance Claims Examiner, you will be responsible for accurately and efficiently processing life life, disability waiver, and other living benefit claims in the event of a qualifying critical, chronic or terminal illness. This includes performing research and other investigative techniques and using your knowledge of life and disability products, state and federal regulations, and company policies to process each assigned claim. You will be responsible for demonstrating excellent customer care over the phone as you empathetically and professionally answer questions for and provide updates to clients who may be going through an incredibly challenging time in their lives. You will also perform account reconciliation, provide backup to team members and complete other office duties.The level of the position will be determined by relevant skills, experience and qualifications. To support the health and safety of our employees, customers, other business relations, and communities, individuals hired on or after October 15, 2021 who work on-site in any Company office, undertake business-related travel, or attend in-person meetings or events related to their position are required to be fully vaccinated against COVID-19 as of their date of hire. Applicants with a disability or a sincerely held religious belief or practice in conflict with the requirements of this policy may request a reasonable accommodation through Human Resources.This position is located in the Binghamton Home Office. Reliable internet service is required due to the impacts of the pandemic.Description of Duties & Responsibilities of a Claims Examiner: --- Confirm that claims have been properly submitted and meet eligibility requirements.--- Handle incoming phone calls according to team rotational schedule and respond accordingly, assisting callers in understanding claims requirements and decisions.--- Process claims through system for payment or denial. Perform follow-up on outstanding requirements in accordance with regulatory guidelines. --- Create new claims files and enter claims data and payments into systems as necessary.--- Assist with claims account reconciliation as needed.--- Investigate life, disability, another living benefit, claims through database searches, obtaining background information and interviewing of claimants and witnesses. Consult professionals, records, and files.--- Assist in handling claims with suspected fraudulent or criminal activity. --- Address inquiries on assigned claims.--- Analyze department reports and take appropriate action. --- Ensure processing time standards are met, follow up is completed and claims processing is resolved within time requirements.Required Skills & Experience of a Claims Examiner:--- Minimum of 3 years of experience in life, disability or supplemental health claims.--- 1-2 years of experience in a life insurance environment preferred.--- Customer service experience.--- Familiarity with medical terminology and Company products strongly preferred.--- Basic proficiency with Microsoft Word.--- Intermediate proficiency with Microsoft Excel.--- Excellent written and verbal communication skills.--- Excellent reading comprehension.--- Excellent judgement and research skills.--- Ability to pay close attention to detail.--- Ability to prioritize and organize a heavy workload.--- Ability to perform work accurately and thoroughly.--- Ability to interpret medical files, reports and information.--- Experience in nursing or closely related field preferred. --- Experience with account reconciliation. --- Prior experience in adjudicating incontestable and contestable death claims is a plus.Education Required: Associate's Degree in Business or related field of study required. Industry courses from organizations such as ICA or LOMA is a plus.To apply: https://workforcenow.adp.com/jobs/apply/posting.html?client=smlny&ccId=19000101_000001&type=MP&lang=en_USVisa sponsorship is not available for this positionRelocation assistance is not available for this positionSecurity Mutual is an Equal Opportunity EmployerAbout SML:Security Mutual Life is a leading provider of life insurance, accumulation products and retirement-, business- and estate-planning services for individuals, families and businesses. Our innovative products help our clients meet their financial protection needs. Headquartered in Binghamton, New York, the Company was founded in 1886 and is recognized for its longstanding history of financial strength and stability.We continually invest in technology. Our agents and employees are equipped with the latest tools and deliver outstanding service to our hundreds of thousands of policyholders throughout the United States.We are committed to our neighbors and communities. Security Mutual and its employees help support a wide variety of community and charitable initiatives and organizations through our donations and service.At Security Mutual our employees are among the Company's most valued assets. We offer competitive salary and benefits and our work environment reflects the Company's core values of trust, respect and integrity.

Keywords: Security Mutual Life Insurance, Binghamton , Claims Examiner - 0953, Other , Binghamton, New York