Senior Claims Administrator – Life, Annuity
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Job Description
Senior Claims Administrator analyzing claims and ensuring timely payments for EMC Life's annuity and health claims. Collaborating with team members for consistent policy interpretations.
Responsibilities:
- Analyzes and investigates claims to ensure compliance and timely payment of benefits
- Responds to agents and policyholders regarding pending claims and appeals
- Processes complex beneficiary and ownership changes and approves eligibility of waivers for life and disability income policies
- Collaborates with peers and management to ensure consistent interpretations of policies and claim payment methods
- Obtains reports, medical records, eligibility, and/or additional information required to investigate and process claims
- Prepares filings for all life reinsurance benefits and tracks status of payments
- Ensures that claims are in compliance with state and federal mandates and reviews for red flags associated with potentially fraudulent claims
Requirements:
- Bachelor’s degree, preferably in insurance or business administration, or equivalent relevant experience
- Three years of experience in life, annuity and/or health claims, or related experience
- LOMA and/or International Claims Association (ICA) certifications preferred
- Strong knowledge of life, annuity, WOP, contestable, and critical/chronic claims processing including federal and state regulations and tax legalities
- Good knowledge of medical and legal terminology
- Strong computer knowledge of Microsoft Suite, Outlook, Access, and insurance administration systems
Benefits:
- Outstanding benefits with life, medical, dental, vision and prescription drug coverage
- Competitive paid time off plan and a full day of volunteer time off annually
- Financial incentives, including a 401(k) plan match, pension plan, and OneEMC bonus plan
- Professional development and growth opportunities, including tuition reimbursement
- Wellness initiatives to improve team member well-being and reduce health insurance costs
- Flexibility to dress for your day and opportunities for alternative work arrangements
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