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Company: The Motorist Insurance Group
Location: Columbus, OH
Job Title: Claims Examiner
The Motorists Insurance Group has an excellent opportunity for a Claims Examiner at our downtown Columbus office. This position is responsible for delivering world class claims service by investigating, evaluating, settling and processes all life insurance claims.
- 2 to 5 years experience with life insurance claims and annuities.
- Understanding of the related policy provisions as well as supplemental benefits provided through riders
- Knowledge of HIPAA and GLBA Privacy guidelines
- Work towards FLMI, ALHC, FLHC or CLU designations
- Superior customer service and communication skills
- The ability to prioritize and accomplish multiple tasks
At Motorists Life Insurance Company, we value, support and invest in our associates. Join our winning team and enjoy our friendly work environment. Let us reward your performance and leadership behaviors with a competitive compensation and benefits package.
For more details and to apply for this position, please visit the career center on our website at www.motoristsmutual.com.
Company: Boston Mutual Life Insurance
Location: Canton, MA
Senior Disability Claim Examiner
- Review and process disability claims and request additional information when needed.
- Answer telephone inquiries concerning claim status, claim filing etc.
- 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
- 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
To be considered for this position, please email your resume to firstname.lastname@example.org.
Company: Western and Southern Financial Group
Location: Cincinnati, OH
Job Title: Director and Chief Underwriting- Posting #5204
Summary of Responsibilities:
Leads Underwriting Department, supporting the application processing, risk assessment and policy issue process for life and health new business and underwriting for W&S Agency, Lafayette Life and/or Columbus Life Insurance Companies. Establishes short- and long-term plans to ensure appropriate risk appraisal decisions for life insurance and new business processing. Leads underwriting staff and makes sure that underwriting guidelines and decisions are in line with corporate objectives. Meets or exceeds service-level standards and scorecard objectives to support introduction of new products, product and system maintenance and specific sales campaigns and initiatives. Leads and develops department managers and associates to ensure staff performance is maximized and evaluated accurately. Accurately assesses strengths and development needs of employees; gives timely specific feedback and helpful coaching; provides challenging assignments and opportunities for development. Builds strong relationships with producers from Enterprise companies. Recognizes the importance of customer satisfaction and utilizes interaction with our field associates to foster strong relationships towards a goal of generating business for W&SFG. Ensures that service levels and quality standards for processing and underwriting are met or exceeded. Ensures overall compliance with federal and state legislation and SEC requirements, including the interpretation of legislative notices, legal consultation as required and procedural/systems changes as required. Serves as a point of contact on behalf of Underwriting with regard to internal and external audits. Evaluates services and systems provided by vendors and negotiates vendor contracting on behalf of Underwriting, utilizing RFP methodology, conducting cost and service comparisons and implementing methods for control. Authorizes vendor payments on behalf of the Enterprise in excess of $5 million annually. Manages reinsurance premium process, authorizing over $26 million in payment annually. Works closely with marketing associates and senior management to encourage and promote profitable new business revenue into our organization and routinely interacts with senior-level management of the Enterprise with regard to daily administration and projects/initiatives.
- Works closely with other Chief Underwriters and the VP & Chief Underwriter to establish underwriting policies and standards. Assures that standards are met so that risks are consistently classified.
- Provides leadership, vision and direction for Underwriting Department.
- Leads and develops department managers to ensure that the staff performance is maximized and evaluated accurately.
- Helps with production underwriting in times of peak volumes or special circumstances.
- Responsible for underwriting large amount cases as well as concurring on cases underwritten by underwriting staff.
- Leverages current and new technology across Underwriting for a service level and strategic advantage.
- Helps support new product development and processing changes or enhancements, creation of procedural documentation and corporate projects and initiatives that impact department reporting to him/her.
- Assists in the establishment of policies and standards in conjunction with the VP, Medical Director and the management staff of Underwriting to assure that policies and processing standards are met, toward an objective of consistently classifying risks which will produce favorable mortality and morbidity.
- Assists in the development and maintenance of reinsurance support for both facultative and automatic reinsurance arrangements. Oversees reinsurance administration including first-year and renewal premium payments totaling $26 million annually. Maintains accurate treaty information and policy data to ensure timely and accurate payment of premium. Establishes and executes self-audits to ensure ongoing quality control.
- Ensures compliance with all federal and state regulations and the Securities and Exchange Commission (SEC) requirements associated with the risk appraisal process. This includes privacy regulation, the Fair Credit Reporting Act, OFAC, SEC requirements, fluid testing and other privacy and disclosure rules. Ensures that product administration, process, procedures and correspondence are compliant at all times. Understands the implications of non-compliance and ensures risk is minimized.
- Serves as a point of contact for internal and external audits, and holds responsibility for audit results.
- Works with other Chief Underwriter and the VP & Chief Underwriter and MDs to help develop underwriting training for the underwriters and for our field associates attending Home Office schools.
- Evaluates services and systems available through various underwriting vendors including laboratory services, paramedical and medical record providers, inspection services and other underwriting service providers. Works with VP to negotiate pricing and implements selected contracts. Responsible for validation and authorization of vendor payments totaling $3 million annually.
- Assists with the direct underwriting budgeting and planning toward a goal of effective expense management. This includes ongoing analysis throughout the year of expense variance results and recommendations of expense reduction changes.
- Assists with the handling of complaints (both formal insurance department complaints and complaints from agents and policy applicants relative to underwriting) and assists the New Business and Claims management in analyzing and/or answering complaints and disputes.
- Seeks customer feedback through surveys and informal communications. Utilizes this customer feedback to evaluate our standards and policies, and works with the Vice President and Director of New Business to initiate process or service improvements. Provides counseling to underwriters on appropriate personal relationship improvement techniques to foster good rapport with the producers.
- Works closely with senior management and distribution partners to evaluate and make appropriate business decisions on customer complaints and requests for business exception. Fully understands implications of decisions made, including potential risk, legal ramifications, loss of revenue, fraud potential, establishment of precedence and impact on business relationship with distribution partners.
- Fosters a culture throughout underwriting that promotes open communications, integrity, professionalism, a sense of urgency and teamwork. Mentors line managers and underwriters to embrace this culture.
- Possesses extensive knowledge and experience in life underwriting.
- Possesses prior management experience, skills and knowledge in insurance, banking or other financial services industry. Demonstrated knowledge of insurance products and regulations.
- Demonstrated success in performance management of direct reports.
- Strong project management skills - must cite examples of developing, organizing, initiating and maintaining a project and successfully accomplishing set goals.
- Proven ability to implement back-office systems and other relevant technologies.
- Proven strong decision-making ability. Must demonstrate a broad range of skill in making decisions that are practical, timely and fair, to include process for gathering of relevant information systematically, giving consideration to a broad range of issues or factors, grasping complexities and perceiving relationships among problems or issues, including others in problem-solving efforts when appropriate and evaluating alternatives. Must be able to show that decisions made benefit bottom-line results of the Company.
- Demonstrated experience in analyzing business processes, identifying opportunities for improvements, presenting and gaining support for the recommendation and successfully implementing the improvement opportunity.
- Demonstrated experience in accounting, budgeting and account reconciliation.
- Demonstrated experience maintaining a calm and professional demeanor when handling stressful situations.
- Possesses and displays excellent verbal and written communication skills with ability to convey information to internal and external customers in a clear, focused and concise manner.
- Proven work experience directing others to initiate a recommended course of action to solve a problem or increase efficiency.
- Demonstrated experience leading, developing and motivating teams. This would include providing direction, coaching and effective feedback to team members.
- Proven experience handling multiple duties and completing assigned tasks accurately and on a timely basis. Cite examples of project management experience in planning, executing and maintaining a project from start to finish.
- Must be able to cite examples from work experience on identifying complex problems, quantifying the problem and providing creative resolutions to solve.
- Proven experience handling and effectively resolving customer problems. Must provide examples of strong customer service skills. Demonstrated knowledge of current organization’s strategy to include customers served, organization’s core competencies and how these competencies are leveraged to offer value to the customer and sustain strategic advantage.
- Possesses strong negotiation skills and has experience "selling" adverse decisions to producers in a clear, concise and positive manner that leaves producers feeling good about the decisions.
- Demonstrated excellent verbal and written communication skills with the ability to successfully interpret and communicate business needs between internal contacts and external contacts in a clear, focused and concise manner. Possesses strong and effective interpersonal skills, expressing self well in groups and one-on-one conversations and has previous experience making numerous formal presentations to large groups.
- Bachelor’s degree in business, or related field, or commensurate selection criteria experience.
Computer skills and knowledge of hardware & software required:
- Proficient in word processing, database and presentation applications. Strong aptitude for the use and creation of spreadsheets.
- Working knowledge of database applications.
Certifications & licenses (i.e. Series 6 & 63, CPA, etc.):
- LOMA – FLMI or FALU preferred.
- Extended hours required during peak workloads or special projects.
- Occasional travel may be required.
If you are interested in this opportunity, you may apply directly online at: http://www.westernsouthern.com/careers.
Questions or you would like to submit your resume for this position? You can contact Lynsey Gaca, Corporate Recruiter, at: email@example.com.
Company: Ameriprise Financial
Location: Minneapolis, MN
Job Title: Senior Life Insurance Claims Analyst
This position performs all activities associated with the settlement of life insurance claims. This includes obtaining appropriate claim documentations, interacting with clients, advisors and outside vendors, ordering specific information and reviewing information submitted to determine benefits.
Focused on people, not just our bottom line. Here, you'll be part of an inclusive, collaborative culture that rewards you for your contributions. You'll work with other talented people who share your passion for doing great work that's in the best interest of our clients. And you'll have plenty of opportunities to make your mark at the office - and a difference in your community. So if you're talented, driven and want to work for a company that cares, put a rewarding career more within reach at Ameriprise Financial.
- Manage client and advisor relationships over the course of the life insurance settlement.
- Determine settlement requirements.
- Request and evaluate medical information as required on contestable life claims. Manage the information as it is received.
- Handle claim referrals from team members and assist other analysts with complex claims as necessary.
- Within designated authority level, adjudicate timely claim payments by determining the type and amount of the claim, verifying in-force status of the insurance policy, confirming policy provisions and determining the appropriate payee of the benefits.
- Coordinate investigative efforts ensuring appropriateness of referral of claims to internal resources and outside vendors.
- Provide thorough review of contestable, foreign and complex claims.
- Understand regulatory requirements related to contracts and insurance claims in general.
- Utilize referral resources and vendors appropriately to manage claim costs throughout the life of the claim. Within approval limits, provide peer review and approvals.
- Provide coaching to peers and proactively provide input to improve process and procedures. Performs other duties as assigned.
- Associate (2-year) or equivalent with 3+ years of experience.
- Understanding of life insurance terminology and life claim settlement practices.
- Ability to work on a team.
- Excellent communication skills both written and verbal.
- Demonstrated problem solving skills.
- Understanding of contract law.
- Excellent organizational skills and the ability to effectively prioritize tasks.
- College or equivalent with 3+ years of experience.
How to Apply: 4545BR : Senior Claims Analyst OR www.joinameriprise.com and search Job ID 4545BR
Company: Massachusetts Mutual Life Insurance Company
Location: Springfield, MA
Job Title: Senior LTC/DI Claim Examiner - #50791341
Employment Type: Regular Full-Time
About Massachusetts Mutual Life Insurance Company
In the world of financial services, it’s all about working with an established, highly respected company based on
demonstrated indications of quality and performance. Who you choose to work with matters. Consider Massachusetts
Mutual Life Insurance Company. Founded in 1851, Massachusetts Mutual Life Insurance Company is the center of the MassMutual Financial Group, a diversified financial services organization. Key subsidiaries include OppenheimerFunds, a leading mutual fund family; Babson Capital Management, a provider of investor services; and Cornerstone Real Estate Advisers, which offers real estate equities. MassMutual has a broad portfolio of products and services including life insurance, mutual funds, money management, trust services, retirement planning products, worksite, annuities, disability insurance and long-term care insurance. MassMutual products are distributed through a nationwide network of trusted and knowledgeable financial professionals who think in terms of long-term commitment to meeting individual client’s needs. Since 1851, MassMutual has made business decisions based on customer needs. Our mutual structure, along with our long-term business approach, has helped keep us strong. This strength means we will be here when our customers need us most. Together, we help people secure their futures and protect the ones they love. MassMutual has maintained some of the highest financial strength ratings in any industry, and is committed to maintaining a position of preeminent financial strength by achieving consistent, long-term profitable growth. In total, MassMutual's worldwide insurance in-force was $ 579 Billion at the end of 2014, and assets under management were $651 billion up 2% and reached its highest point in history. MassMutual is ranked 96 on the 2014 Fortune 500 list and was again honored by Working Mother magazine as one of its “100 Best Companies”. DiversityInc for the fourth consecutive year, names MassMutual one of its “25 Noteworthy Companies” and for the first time as one of it “Top 10 Companies for LGBT Employees”.
Associates at this level have acquired the advanced skills necessary to expertly adjudicate LTC/disability income and life
waiver of premium claims of high complexity. An extensive knowledge of disability income policy and rider provisions as well
as life waiver of premium riders has been demonstrated. With a high degree of autonomy and discretion, incumbents
independently identify core claim issues, develop and execute investigative action plans to obtain essential information, and
analyze claim information with the assistance of appropriate subject matter experts (medical, vocational, financial, legal, etc). Independent field investigative work may be performed. After considering claim facts and policy coverage, incumbents make or recommend initial and ongoing liability determinations on disability income and life waiver of premium claims and authorize benefit payments as appropriate within specified authority limits. Partners with counsel in representing company at arbitrations, mediations and trials. Exceptional customer service through oral and written communications is required in
accordance with internal and regulatory standards. Mentoring, providing second approvals and other department monitoring functions may be assigned to these associates. Will participate in and also lead projects.
• Handles projects or work with defined scope in own discipline and typically has a short-term focus
• Works with guidance on small-scale team/unit projects
• Solves problems in own specialty area
• Makes worthwhile improvements to existing programs, and procedures
• Makes practical suggestions for improving work processes in own area
• Works for consensus and contributes to achievement of work group goals
• Individual typically has at least 2-5 years of related experience
Job Responsibilities & Requirements
• Properly adjudicate LTC/Disability Income and Life Waiver of premium claims
• Identify core claim issues, develop and execute investigative action plans to obtain essential information, and analyze
claim information with the assistance of appropriate subject matter experts (medical, vocational, financial, legal, etc)
• Recommend initial and ongoing liability determinations on LTC/Disability Income and Life Waiver of premium claims,
and authorize benefit payments as appropriate within specified authority limits
• Ability to interpret and apply policy language
• Use experience gained from handling of LTC cases to identify and recommend system and procedural enhancements
designed to improve the level of service provided to LTC customers thereby reducing both justified and unjustified complaints
• Individual will be required to mentor and coach individuals on LTC processes/procedures and industry practices
• Drive and support continuous improvement throughout the Claim Dept. Improve processes to provide a better
• 3+ years of LTC experience with the ability to demonstrate solid knowledge of LTC claims processes and industry
• 4+ years of customer service experience with the ability to demonstrate exceptional customer service skills through
oral and written communication skills, in accordance with internal and regulatory standards
• 4 year college degree or equivalent of work experience
• Qualified candidates must be authorized to work in the US for any employer, without requiring Visa sponsorship
• Must be flexible, able to work independently and be self-driven
• Focus on the Customer: Know your customers well; add value with a sense of urgency.
• Act with Integrity: Be trustworthy, adhere to high ethical standards and adhere to the letter and spirit of applicable laws,
rules, regulations and company policies
• Value People: Lead people to success; appreciate diverse backgrounds, ideas and experiences.
• Work Collaboratively: Partner with others to achieve results that leverage the right resources
• Achieve Results: Focus on winning; consistently exceeds expectations, beat the competition
MassMutual Financial Group Financial Group is an Equal Employment Opportunity employer Minority/Female/Sexua
How to Apply:
To be considered for this position, please email your resume to
Company: Banner Corporate Center Mesa
Location: Mesa, AZ
Job Title: Claims Processing Director
Banner Health is currently seeking a Claims Processing Director. The Reimbursement Services department is responsible for claims adjudication, recovery and management for Banner Choice Plus/Select, Blue Advantage, HealthNet Medicare Advantage and UHC Medicare Advantage. They are also responsible for management of the eligibility and funding for Banner Choice Plus and Select.
You will provide leadership by directing the planning and implementation of the reimbursement systems, annual enrollment and eligibility, network data management, Active Health maintenance and benefits administration functions for the company’s self-funded employee benefit plans, commercial risk, capitation, Medicare Advantage Plans, special payment plans and Third Party Administrator (TPA) contracts. You will develop, implement, and manage business processes and procedures necessary to ensure high levels of performance, accuracy, and operational integrity.
To thrive in this position, you must possess:
- Knowledge typically gained from the completion of a Bachelor's degree in the business, finance or healthcare administration field or the equivalent training and experience
- Experience in reimbursement, claims and related systems, provider contract interpretation, system development, typically achieved with seven or more years’ experience, including supervisory experience
- Demonstrated proficiency in implementing complex provider compensation models. Analytical and critical thinking skills required to interpret diverse data requirements
- Ability to integrate information to establish business-based priorities, decisions and budgets and ability to develop strong relationships with suppliers and customers and to effectively communicate with employees, providers, the medical staff, and Healthcare, Hospital management staff
For immediate consideration, apply directly https://jobs-bannerhealth.icims.com/jobs/136527/claims-processing-director/job or visit www.BannerHealth.com/careers for more information.
About Banner Health (Corporate)
Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. With locations in Phoenix and Mesa, we offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.
About Banner Health
Banner Heath is a comprehensive, award-winning, nonprofit health system with facilities in seven western states. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices, and much more, our skilled and compassionate professionals use the latest technology to change the way care is provided. The many locations, career opportunities and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.
EOE/AA. We support a tobacco-free and drug-free workplace.
Company: National Life Group
Location: Vermont or Texas campus
Job Title: Senior Life Claims Examiner
Senior Claim examiners are accountable for determining the extent of the Company’s liability in Claims under all forms, and all amounts of its in-force life insurance portfolio, in-force disability insurance and waiver of Premium/Monthly deduction portfolio. In addition, they authorize settlement thereof in compliance with contractual provisions, company practice and philosophy and the various governmental and judicial laws and regulations regardless of complexity or circumstances.
- Acquire a thorough understanding of the various life, annuity and disability insurance products and riders in-force on the Company’s books including any liberalization
- Pioneer in new products, in documenting, administering and processing for the first time
- Conduct or direct any necessary investigation to determine the extent of Company liability in claims which apparently present no substantial settlement questions
- Authorize and direct settlement of life insurance claims including matured endowments, annuities and claims under installment certificates in accordance with decision authority established
- Authorize and direct settlement of disability income payments including waiver or premium / waiver of monthly deduction / Waiver of Target premium / Waiver of specified premium; this also includes denials and the explanations and reasoning in the communication process
- Authorize and direct settlement of Accelerated Benefit claims that vary by type and company; this also includes denials and the communication with explanations and reasoning
- Contribute to the conduct or direction of investigations regarding claims which do present a substantial question of Company liability and/or settlement issues, recommend action concerning misrepresentation, suicide, accidental deaths, disappearance, fraud and other situations
- Responsible for the co-approval authorization and direction of settlement in claims exceeding the single decision authority levels of other claims examiners
- Develop understanding and application of medical terminology, insurance law, tax law and financial principles
- Communication daily in writing and verbally with policy owners, agents, attorneys, beneficiaries and physicians in the review, approval or denial of all claims
- Work closely with law, compliance, reinsurance companies, actuarial, underwriting and others to maintain the contractual provisions and company practices
- Training, communicating, reviewing, co-approvals and referral for claim examiners and trainees
- Bachelor’s Degree preferred; medical/clinical coursework a plus
- LOMA course work towards the FLMI designation would be very beneficial and considered a plus
- Completion of al ICA, and ALHC Program courses
- Attention to detail and the ability to work efficiently under pressure is essential
- Maintain confidentiality and strong professional client relationships
- Understand and follow oral and written instructions
- Work independently in the absence of supervision
- A strong work ethic and a demonstrated ability to work independently in a fast-paced environment with a high degree of accuracy
- Establish and maintain effective working relationships with those contacted in the course of work
- Proficient use of personal computer (PC) to include Microsoft Word, Excel and Outlook
- Must be able to successfully complete a background check
National Life Group® is a trade name of National Life Insurance Company, Montpelier, VT, and its affiliates.
Application Link: https://chj.tbe.taleo.net/chj01/ats/careers/requisition.jsp?org=NATILIFE&cws=37&rid=743
About the company:
National Life Group is a diversified family of financial service companies that offer a comprehensive portfolio of life insurance, annuity and investment products to help individuals, families and businesses pursue their financial goals.
National Life Group, a Fortune 1000 company, serves 786,000 customers. With 2013 revenue of $2 billion and net income of $142 million, members of National Life Group employ roughly 900 employees, with most located at its home office in Montpelier, Vermont. Group companies also maintain offices in Addison, New York, and San Francisco
The Group is made up of its flagship company, National Life Insurance Company, founded in Montpelier, Vermont in 1848; Life Insurance Company of the Southwest, founded in 1955, Addison, Texas, and Sentinel Investments and Equity Services, Inc., all based in Montpelier.
We offer all that you would expect from a major corporation: a choice of health care plans, pension plan, 401(k), life insurance, short and long term disability, and more. Our company highly values community and the environment. We offer a variety of benefits that are far from common. For instance, each employee receives up to 40 hours of paid volunteer time, and the company provides incentives for employees to use alternate forms of transportation, such as gas cards for car poolers and preferred parking for fuel efficient vehicles. Opportunity and development are more than just words to us. We offer tuition reimbursement, support for achievement of professional designations, and the newly established National Life University, offering a variety of courses for personal and professional growth.
All postings will remain for 60 days unless otherwise noted
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