[Hiring] Claims Adjudicator @National Guardian Life Insurance Company

Role Description

The Claims Adjudicator is responsible for processing claims, effectively communicating and corresponding with external and internal customers including policyholders, agents, funeral directors, and beneficiaries. Additional responsibilities include processing various types of claims and service requests along with providing phone support accurately within or exceeding existing service goals. In this role, work is performed under general supervision. The position requires the need to conduct additional research and to accurately document all findings as deemed appropriate.

Primary Responsibilities

• Accurately adjudicate claims within stated service goals.
• Follow established written processing procedures.
• Verify proper forms are received according to state regulation.
• Accurately enter and process:
  • Whole life
  • Term Life
  • Universal life & Interest sensitive
  • Acquisition Preneed
  • Final Expense
  • Preneed
  • Trust claims including Tru Trust, NGL Funeral Expense Trust, and NGL Estate Planning Trust
  • Preneed Texas including accurate reconciliation and file documentation verification.
  • Annuities
  • Contestable claims including referring claims to Underwriting as needed.
  • Rider claims including accidental death, child/family rider, and spouse rider.
  • Accurately calculate cost basis on basic annuity claims.
• Follow-up timely on all claims in writing within state regulated time frames.
• Provide phone support for all claims related calls and letter correspondence.
• Ability to effectively communicate, with empathy when appropriate, to our customers verbally, in writing, and via email.
• Ability to actively listen and appropriately respond to others.
• Contact agents, funeral homes beneficiaries, and other customers to obtain missing information when needed.
• Prepare proper correspondence for all steps in the claim process and as needed to respond to customer inquiries.

Team Work

• Ability and willingness to work with others in a team environment.
• Participate in group decision making, listening, and responding constructively to others.
• Offer help to teammates when the need arises.
• Manage and adjust personal time off, breaks, and lunches to ensure sufficient team coverage.
• Help ensure that team standards and goals are maintained.

Problem Solve

• Transfer knowledge from one process and apply it to another like process regarding common situations.
• Able to gather most needed data and petition input to help recognize the symptoms and root causes of distinct problems.
• Examine defined issues with ambiguous causes.
• Suggest alternative approaches that meet the needs of the organization, the situation, and those involved.
• Resolve difficulties and escalate issues with suggestions for additional inquiry.
• Accurately research insured status.
• Follow established written processing procedures.
• Search databases to confirm Insured status.
• Update spreadsheets and document appropriately.
• Complete assigned projects, tasks, and/or milestones by agreed upon due dates including performing other related work as requested or required.

Essential to Your Success

• Intermediate knowledge of NGL and acquisition products and procedures.
• Intermediate communication skills--oral and written.
• General PC and office machine knowledge.
• Typing skills of at least 45 words per minute and 5500 keystrokes per hour alphanumeric.
• Knowledge of basic accounting skills.
• Ability to work in a team environment.
• Organized and detail oriented.
• Ability to quickly search the Internet and other databases.

Education Requirements

• Minimum: High School or GED.
• Preferred: Other
  • LOMA Level I Certificate
  • LOMA ACS
  • Wisconsin Preneed Certification

Years of Experience

• One year claims processing experience or equivalent business experience.
• Two years customer service or insurance/financial experience preferred.

Benefits

• 20 days of Paid Time Off growing to 25 days after 5 years.
• 11 Paid Holidays (10 company holidays and 1 personal holiday of your choice).
• Health care, dental and vision plans.
• Up to $1,500 (Family) or $1,000 (Single) annually towards a Health Savings Account.
• Annual bonus based on company performance.
• Paid Parental Leave.
• 401(k) match up to 9%.
• Paid Sabbatical after 8 years.
• Paid Volunteer Time.
• Education Assistance Program.
• Employee Recognition Program.
• And much more!