There are currently 4 job posts in the Job Bank.
Interested in posting a job to the ICA Job Bank? As part of your ICA Membership all posts to the job bank are free and will remain on the site for 60 days!
If you're not a member of ICA there is a $250 charge to post to the website for 60 days.
Interested in becoming a member? View our member benefits and fill out an application for membership here.
Please forward posts to Darci Chuba at firstname.lastname@example.org
Company: Boston Mutual Life Insurance Company
Location: Canton, MA
Job Title: Bilingual/Disability Claim Examiner
Boston Mutual Life Insurance Company was founded in 1891 and has been a stable financially strong company for over 120 years.
Boston Mutual is proud to promote our corporate principles of Service, Value, and Integrity. As well as being a financially strong and reputable company to do business with, Boston Mutual offers its employees a wide array of competitive benefits to full time employees including Health, Dental, Life and Long Term Disability Insurance, generous paid vacation time, on-site fitness facility, free parking, 401K program, FSA, tuition reimbursement, and an employee assistance program as well as offering flexible work schedules. We are currently looking for an experienced Bilingual/Disability Claim Examiner to join our fast-paced Claims team.
- Review and process disability claims and request additional information when needed.
- Answer telephone inquiries concerning claim status, claim filing etc.
- Answer telephone inquiries from our Spanish customers.
- Written Spanish translations.
- Handle all written correspondence regarding claims and additional requests when needed
- Read and evaluate policy/contract provisions
- Review pending claims on a monthly basis
- Be aware of compliance issues
- Read medical records
- Must comply with privacy guidelines; protect the privacy of customer information
- Perform other duties as required
- Minimum of 2 years insurance experience; LOMA courses preferred
- This position requires an individual with strong analytical skills. Must be well organized, detail oriented, able to work independently and successfully works as part of a team
- Must be able to communicate in Spanish
- Microsoft Office skills including Word, Excel and Access are required; Knowledge of ALIS a plus
- Medical Terminology preferred
- Excellent verbal and written communication skills
- • Must be able to meet deadlines and handle large volume of work
- Excellent attendance and punctuality required
- Bilingual (English/Spanish)
Forward resumes in confidence to Kathy_Welch@bostonmutual.com
Boston Mutual Life Insurance Company
120 Royall Street, Canton, MA 02021
Fax: (781) 770-0575
Tel: (800) 669-2668
Company: Aria Health
Location: Philadelphia, PA
Job Title: Director, Insurance and Claims
With your minimum 5 years of professional and general liability claims management or related law firm experience, this could be the ideal opportunity for you to join the largest healthcare provider in Northeast Philadelphia and Lower Bucks County.
You will manage all general and professional liability claims activity including management of third party vendors, insurance providers and other service providers. You will also use system and cost containment strategies as they relate to claims quality and efficiency, with defense counsel establish a claim resolution strategy, coordinate discovery process, assess potential liability, and supervise work done by outside counsel.
Additionally, you will monitor case/file management, trials and arbitration to assess insurance company and defense counsel performance, observe proceeding and report status to senior administration identifying claim patterns and possible trend analyses. And, you will conduct relevant education programs and presentations to physicians and system employees.
- Bachelor's degree required
- Candidate should possess or be working on graduate degree
- Five years experience in professional and general liability claims management with experience in a self-insured environment preferred
- Extensive experience in management of catastrophic and large loss malpractice and general liability claims
- Pennsylvania MCare Fund negotiations experience
- Excellent leadership skills, effective communication and collaboration with senior management and staff
- Possess excellent written and verbal communication skills at all levels
- Presentation and interviewing/ investigation skills
- Current PA driver's license required
A progressive health care employer, Aria Health offers team members a competitive salary and benefit package, tuition reimbursement, access to family and caregiver support services, free parking, as well as discounted employee fitness center memberships.
To apply for this Philadelphia area (Neshaminy) position, visit www.ariahealth.org, click on Career & Education, then Employment. Search under Management/Director. AA/EOE, M/F/D/V
Company: Legal & General America (Banner Life Insurance Company)
Location: Urbana, Maryland
Job Title: Claims Representative
Job Classification: Non-exempt
The Claims Representative is responsible for the set up, research, review and processing of non-contestable claims within established productivity and quality standards. Complete all other claims related tasks to meet or exceed pre-defined productivity and quality standards. Complete other administrative duties and projects as directed by management.
- Set up, research, review and process non-contestable claims within established productivity and quality standards.
- Review company records to confirm insurance coverage.
- Review all beneficiary and title changes and collateral assignments for correctness and generate appropriate correspondence in accordance with state insurance regulations requesting appropriate claim requirements.
- Open up claims files according to departmental procedure. Notify reinsurer of death or waiver claim.
- Review file to determine eligibility for fast track claims processing and request appropriate documentation.
- Evaluate documentation submitted for processing of claim and confirm its eligibility for payment utilizing knowledge of estates, trusts, minor beneficiary requirements, divorce statutes and other regulatory requirements. If documentation is insufficient, request correct or additional requirements needed in order to give the claim further consideration.
- Correspond and communicate with claimants, attorneys, agents, reinsurers and other company departmental staff to discuss and/or resolve matters relevant to effective claims administration, including competing claim issues.
- Review progress and status of pending claims with management and discuss problems and suggested solutions.
- Follow up on all pending non-contestable claims within established regulatory requirements.
- Follow established escheat procedures on pending claims review and approve disbursements up to $5,000.
- Process claim on administrative systems using the appropriate Post Mortem Interest statutes, dividend calculations and contract provisions to reflect settlement or payment of claim to the appropriate party.
- Send disbursement correspondence and document file reflecting interest and payment amount.
- Document all activity to support claim file
- Answer phones and respond to correspondence pertaining to the initial notification of death, waiver and health claims.
- Keep abreast of “red flags” for fraud and identify potential issues to prevent payment of fraudulent claims including foreign death requirements.
- Complete form 712’s as needed.
- As required, bill reinsurer for their share of the liability and update appropriate system. Communicate with reinsurers as needed on problem cases.
- Review and process 3rd party invoices for payment.
- Keep abreast of claims related regulatory requirements.
- Operate in a team environment and support other team members to enhance overall productivity.
- Complete all other projects and tasks as assigned by management.
- High School diploma or equivalent
- College preferred
- 3+ years of experience in life, property and casualty or health claims
- Proficient typing skills
- Proficiency in spreadsheet and word processing software
- Detail oriented
- Strong organization skills
- Outstanding verbal and written communication skills
- Superior customer service skills
- Good problem solving and negotiation skills
- Strong product knowledge and proficiency in understanding basic contract language
- Good analytical skills
- Ability to work in a fast-paced environment
- Flexible with regard to work hours and overtime
- Knowledge of Microsoft Office
Please visit our career site, https://careers-lgamerica.icims.com/
Company Website: www.lgamerica.com
Bloomfield , CT
Job Title: Appeals Specialist
Conducts timely reviews and analysis of adverse benefit determinations on short-term disability claim files received on appeal. Renders final determinations in accordance with ERISA laws, regulations and customer plan provisions.
- Conducts reviews of denied and terminated disability claims for accuracy of determinations by taking into consideration contract provisions, medical documentation, vocational, and employment information.
- Identifies questionable aspects of the claim to determine the need for additional information, taking into consideration contract provisions, clinical information as well as vocational evidence already on the claim.
- Refers the claim for clinical reviews and vocational assessment as warranted based on initial determination.
- Conducts timely reviews in accordance and compliance with the Employee Retirement Income Security Act of 1974 (ERISA) and customer specifics.
- Responds to inquiries in a timely manner.
- Prepares clear and concise written correspondence with claimants, policyholders, and attorneys in a timely manner.
- Updates appeals fields correctly and in a timely manner.
- Identifies opportunities and issues for ongoing improvement of the process.
- Performs other related duties as assigned or required.
- Ability to work collaboratively and build relationships
- Demonstrates flexibility and the ability to adapt to change
- Solid analytical and interpretive skills
- Excellent listening and interpersonal skills
- Ability to communicate clearly, logically, and diplomatically, both verbally and in writing
- Demonstrates sound business judgment in final claim determination
- Ability to clearly deliver the rationale regarding the claim decision
- Ability to prioritize multiple tasks to meet ERISA and Department of Labor (DOL) guideline
- Strong customer service orientation
- Ability to work independently with minimal supervision as well as collaboratively with others
- Must have at least 3 years of STD and/or LTD claims or case management experience.
- Knowledge of Employment Retirement Income Security Act of 1974 (ERISA)
- Intermediate skill-level with MS Word and Excel
- In depth knowledge of contract provisions and claims workflow process
Senior Recruiter - MetLife
All postings will remain for 60 days unless otherwise noted
Home | Membership
Info | Who's Who | Committees
| Member Companies |
Education Program | Publications | Regional
Meetings | Job Bank | Claims
Resources | Industry Links
© International Claim Association
1155 15th Street, NW • Suite 500 • Washington, DC 20005
Phone: (202) 452-0143 • Fax: (202) 530-0659 • E-mail: email@example.com