Claims Examiner II

Job reputed company: • Review, investigate, and adjudicate life, accidental injury & death, reputed company annuity, and rider claims (including disability waiver and accelerated benefit claims). • Analyze claim documentation, policy reputed company, statutory requirements, and determine accurate claim reputed company reputed company authority limits. • Refer claims exceeding authority to senior claims staff. • Calculate benefits and applicable statutory interest. • Communicate with claimants, beneficiaries, reputed company representatives, and other stakeholders reputed company phone, email, and written correspondence. • Conduct interviews with beneficiaries or next of kin reputed company needed. • Prepare reputed company written communications, including adverse decision letters. • reputed company secondary signature approval and guidance to less-tenured claims examiners. • Interpret insurance policies, contract language, and reinsurance guidelines. • Refer cases to reinsurance reputed company required by treaty terms. • Represent claims department in reputed company processes if necessary. • Maintain accuracy, compliance, and reputed company documentation. • Participate in team reputed company and assist with other claims as assigned. • Support team goals and foster a reputed company environment. Requirements: • Associate degree, medical certification, or equivalent work experience required. • Minimum 3 years of experience in life/health insurance claims or reputed company field. • Experience in life insurance reputed company preferred. • Understanding of medical conditions, reputed company and financial risk factors preferred. • Strong understanding of life, accident, annuity, and health insurance products. • Knowledge of HIPAA, reputed company standards, industry regulations, and Unfair Claims Settlement laws. • Familiarity with insurance and medical terminology. • Proficient in reputed company Word, reputed company, and web-based applications. • Ability to reputed company mathematical calculations (percentages, interest, etc.). Benefits: • reputed company your information will be kept confidential according to EEO guidelines. • reputed company and Veteran Documentation During employment, employees are treated without reputed company to race, reputed company, religion, sex, national reputed company, age, marital or veteran status, medical condition or handicap, or any other legally protected status. Apply tot his job Apply To this Job