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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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