Claims Specialist - West Des Moines, United States - EquiTrust Life Insurance Company

Description

The Claims Specialist works collaboratively with team members, as well as independently, to accomplish their daily tasks and duties, with the ultimate goal of providing excellent customer service. This individual supports claims processing by examining beneficiary designations and performing associated due diligence. This individual is responsible for examining newly received claims, and indexing them to the correct queues. The Claims Specialist is expected to communicate effectively, resolve issues as they arise and prioritize workflows to accomplish daily duties.

Essential Duties and Responsibilities:

• Examines and coordinates proper indexing of all documents associated with death claims and living benefits.
• Understands, monitors, follows, and complies with State due diligence requirements associated with follow-ups on outstanding claims.
• Examines documents for proper and/or missing beneficiary designations.
• Performs Accurint searches for address and SSN verifications and analyzes the information to ensure the correct information is captured.
• Communicates both verbally and in writing with stakeholders including agents, IMOs, claimants, beneficiaries and other departments.
• Responds to agent, independent marketing organization and policy holder inquiries by clarifying desired information, researching, locating and providing follow-up responses within set department standards.
• Performs claims coordination and examination of annuity and claims.
• Adheres to and understands state regulatory requirements for administering annuity and life claims.
• Demonstrates strong written and verbal communication skills with follow through with internal clients regarding exceptions or changes in procedures.
• Proactively escalates issues to management and assists with solving issues that do not have procedures or precedent.
• Identifies computer system deficiencies, or process/procedure improvements and collaborates with department manager in preparing requests for programming updates, modifications, and procedure updates.
• Participates in the testing of new enhancements to administration systems and works with IT to correct any errors.
• Trains new staff on EquiTrusts processes, procedures and state regulations.
• Sets a good example and provides a positive influence within the department.
• Meets job-specific quantitative and qualitative performance standards and metrics.
• Reads and correctly interprets contract language to understand the terms, conditions, and obligations outlined as it relates to living and death claims. In turn, exercises good judgement and decision-making skills in interpreting the information provided.
• Serves as the initial step in the claim process to assess whether the received document meets certain criteria before proceeding further evaluation or forwarding the document to the appropriate work queue.
• Supports Policy Administration team and other departments on an as needed basis.
• Willingly takes on additional responsibilities as requested in order to accomplish department and Company objectives.
• Actively participates and contributes to the goals and objectives of the Company by working collaboratively and fostering a positive and inclusive work environment.
  
  

• Must possess a professional and friendly attitude and be able to quickly develop rapport with customers.
• Ability to learn and retain a large amount of detailed information regarding EquiTrust life and annuity products.
• Must have good mathematical, analytical, organizational, and problem-solving skills, attention to detail with a strong sense of urgency.
• Effective communication and presentation skills, both verbal and written.
• Strong phone presence and skills in handling escalated calls under pressure.
• Ability to prioritize workflows, establish and meet deadlines and manage multiple concurrent tasks.
• Ability to work effectively in a variety of situations and respond to change in a positive manner.
• Intermediate computer skills and the ability to navigate multiple systems and programs including Microsoft Office, proprietary systems and other technology solutions.
• Strong interpersonal skills are required, including a high degree of professionalism.
• Ability to meet attendance and punctuality standards.
• Carries out responsibilities in a manner that is consistent with EquiTrusts Core Values and focus on customer service; helps to create an environment of openness and trust for all employees and strives for continued professional skills development.
  
  

• Minimum 6 months of death claims processing experience preferred.
• 1 year experience of life and annuity insurance preferred.

• High School Diploma or Equivalent

• Business Travel: Travel not required/likely.