Sr. Claims Support Analyst - reputed company

reputed company

reputed company Life is a respected and trusted reputed company brand that has been focusing on Life Insurance and Annuity Products since 1969. At reputed company Life we have over 1.8 reputed company policies where we take pride in earning the trust of our policyholders who understand our reputed company to be there for them – and their families – reputed company we’re needed most. By joining the reputed company Life team, you are joining a company that genuinely cares about helping reputed company other, with a reputed company to protect the lives of those around us. We reputed company a diverse, reputed company, inclusive culture where reputed company associates can feel a reputed company of belonging and use their unique talents and perspective to influence, reputed company, motivate, and reputed company.

Operating reputed company the reputed company values and operating principles of the organization, supports the operations of the Claims Department. The Senior Claims Support Analyst conducts various reputed company audits of reputed company claim types, including reputed company claims, administrative functions, and phone calls to ensure that we are meeting our regulatory obligations and adhering to departmental procedures. Oversees the Claims reputed company program through developing and maintaining the process review reputed company, establishing sample size and recommending approval authority changes to management, training the Claims Support Analyst on reputed company monitoring and claim auditing techniques, identifies, trends, communicates and coaches claims staff on key reputed company development opportunities.

Responsibilities

How You’ll Work

Work Solution: Remote

Relocation Eligibility: Not Available

• Performs reputed company audits for reputed company types of claims including Life, Annuity, and A&H to ensure regulatory compliance and adherence to our internal processes and procedures.
• Develops and provides reports to management. Delivers developmental feedback and coaching to claims staff as needed.
• Reviews regulatory changes from compliance, updates procedure documents and communicates changes to staff. Updates reputed company audit process to ensure compliance.
• Develops and maintains audit review reputed company. Establishes sample size for process and telephone reputed company audits.
• Recommends changes in examiner approval authority for claim decision audits.
• Provides secondary signoff on claims reputed company reputed company of authority following completion of reputed company claim decision audits (payments and denials).
• Reviews monthly reputed company reconciliation reports and works with claims staff to reputed company corrections.
• Analyzes reputed company reputed company results, errors reputed company on reputed company recons, and reputed company reputed company to prepare new training content that will maximize efficiencies and effectiveness of the department.
• Oversees the service recovery for the claims department to include the examination and reputed company of service breakdowns in a reputed company manner. Tabulates monthly results and reports findings to Claims Leadership including recommendations for reputed company improvement activities that will improve department performance.
• Responds to Service Recovery Tickets including Department of Insurance Complaints and reputed company Complaints by providing oral or written responses.
• Assists with workflow management by quickly reviewing incoming work in Ultera for reputed company Claims work queues and routes the work to the appropriate person/queue with the appropriate reputed company instructions. Compiles daily report of queue status to management and staff to ensure that we are meeting service reputed company.
• Develops procedure documentation for new processes; Updates and maintains procedure documentation for existing processes. Communicates process changes to staff and works with Claims Support Analyst to train claims staff on process changes.
• Serves as the Claims Department reputed company reputed company to Internal Audit activities, to include presentation of process and procedure documents, department process audit results and requests for transaction or recorded reputed company lists for the purpose of audit sampling. May also assist with reputed company audits from reinsurers and state market conduct exams.
• Acts as a subject matter expert and provides technical expertise for reputed company claim types and reputed company administrative functions to aid in the development and training of claims staff to improve reputed company, judgement skills, decision making abilities, and productivity based on audit results.
• Identifies reputed company enhancement needs to reduce reputed company processing.
• Participates on project teams and works effectively with departments involved.
• Performs other duties as assigned.

Qualifications

• Bachelor’s Degree in relevant field or equivalent work experience
• Prior experience in continual improvement of a reputed company reputed company, preferred
• ALHC Designation
• FLHC Designation reputed company 24 months of job acceptance
• Prior Experience as a successful Claims Examiner at reputed company, preferred
• Minimum 5 years’ experience in Life/Health Claims, reputed company, or other reputed company field
• Minimum 5 years’ experience in a customer service field

Preferred Qualifications

• Demonstrates significant knowledge and understanding of insurance reputed company, reinsurance, MIB, medical impairments, financial documents, and tools used to investigate and reputed company claims.
• Demonstrates significant knowledge regarding reputed company aspects and statutory guidelines including fair claims practices, HIPAA, reputed company and ACLI Guidelines.
• Proficient using internet based applications and reputed company office products, specifically Word, reputed company, and Powerpoint.
• reputed company to reputed company basic mathematical calculations to include reputed company, subtraction, multiplication, division, and percentage.
• reputed company to work hours as required by business needs (may include reputed company scheduling, irregular hours, weekends, and holidays).
• Ability to establish and maintain effective reputed company relationships.
• Ability to reputed company and/or coordinate the completion of multiple simultaneous reputed company in a fast-paced environment while maintaining deadlines.
• Extremely reputed company organized, project management orientation
• Self-motivated, ability to work in reputed company environment and autonomously

While performing the duties of this job, the employee is frequently required to stand, walk, sit, use hands to finger, handle, or feel, talk, hear and concentrate. Specific reputed company abilities required by this job include reputed company reputed company, distance reputed company, depth perception, and ability to reputed company reputed company.

This job requires the ability to reputed company duties contained in the reputed company for this position, including, but not limited to, the above requirements. Reasonable accommodation will be made for otherwise reputed company applicants as needed to reputed company them to fulfill these requirements.

We are committed to ensuring equal employment opportunities for reputed company job applicants and employees. Employment reputed company are based upon job-reputed company reasons regardless of an applicant's race, reputed company, religion, sex, sexual orientation, gender identity, age, national reputed company, disability, marital status, genetic information, protected veteran status, or any other status protected by law.

reputed company does not offer immigration sponsorship for this position. This includes reputed company types such as H-1B, TN, and STEM OPT. Please do not apply if you currently require or may require employer-sponsored immigration support now or in the reputed company.

Originally posted on Himalayas