Claims Examiner (Annuity)

Evaluate and analyze documentation for claim payments or denials according to the policy/certificate provisions and state regulations, with limited authority limits.

Requirements

• Under direct supervision, analyze information/documentation received to determine how to proceed with a review of a claim and determine methods of obtaining additional information from alternative sources.
• Review claims and outside sources used in the review.
• Document correspondence and conversations.
• Correspond verbally and in writing with claimants, medical providers, medical examiners, and law enforcement.
• Work closely with department manager, legal counsel, medical director, claims assistants, and other departments to gather information for contested claims.
• Monitor claims for fraud and proceed according to each situation, such as engaging the Fraud team or additional research.
• Maintain compliance with regulations.

Benefits

• Pension Plan
• 401k Match
• Employee Stock Purchase Plan
• Tuition Reimbursement
• Disability Insurance
• Medical Insurance
• Dental Insurance
• Vision Insurance
• Employee Discounts
• Career Training & Development Opportunities
• Paid Time Off
• Ten (10) paid holidays per year
• Be Well Company holistic wellness program
• Parental Leave
• Adoption Assistance
• Employee Assistance Program
• Back-Up Care Program
• PTO for Volunteer Hours
• Employee Matching Gifts Program
• Employee Resource Groups
• Inclusion and Diversity Programs
• Employee Recognition Program
• Referral Bonus Programs