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Company: Optimum Re Insurance Company
Location: Dallas, TX
Job Title: Reinsurance Life Claims Analyst
Responsible for timely handling and adjudication of individual life, accidental death, waiver of premium, and critical illness claims.
Main Areas of Responsibility
- Perform various duties relating to life, accidental death, waiver of premium, and critical illness claims including (1) reviewing for completeness and accuracy, (2) verifying consistency with policy contract and treaty provisions, and (3) approving payment or denial
- Identify the more complex claims and establish basic knowledge of their adjudication
- Communicate with clients, retrocessionaires, internal staff, and physicians on claim related issues
- Create and maintain monthly and quarterly reports for our retrocessionaire partners
- Prepare and execute verbal presentations of individual claim related issues
- Discuss claim adjudication developments with clients
- Communicate (written and verbal) with retrocessionaire partners regarding non-adjudication claim issues
- Provide assistance and feedback to Claim Analyst as needed
- Remain aware of industry customs and company internal processes and procedures
- Other duties as assigned by management
Major Challenges Encountered in This Position
- Balancing the need to meet time-sensitive deadlines while providing a quality deliverable
- Communicating with individuals on various levels of the organization as well as individuals at our client companies and retrocessionaire partners
- Obtaining an authority limit to adjudicate some claims
Essential Knowledge, Skills and Abilities
- College degree
- 5 years of life insurance claims adjudication
- Ability to handle multiple priorities effectively and meet deadlines
- Strong contract interpretation, organizational, communication (written and verbal), analytical, and customer service skills
- Excellent interpersonal skills and client focus
- Ability to effectively communicate with managers and colleagues of other departments
- Advanced knowledge of reinsurance and/or insurance industry customs and practices
- Good technical knowledge of claim adjudication
- Ability to work in a team environment
- Good mathematical proficiency
- ALHC and ALMI professional designations
- Intermediate proficiency of Microsoft Office products (Word, Excel, and Access) and Oracle Discoverer (or equivalent report writing software)
- Proficient in using proprietary systems: GRP, ALFRED/DAVE, Datamart preferred
If you are personable, communicate well with others, are client focused, enjoy multitasking and excel at paying attention to detail, we encourage you to submit your resume for consideration!
Candidates can submit their resume by emailing resumes to: email@example.com
Secured Fax: 1-866-867-0244
Company: Northwestern Mutual
Location: New York/ New Jersey
Job Title: Field Benefit Consultant
About Northwestern Mutual
A Foundation for Life - that's Northwestern Mutual's promise. We are a financial services provider that has delivered consistent and dependable performance, and we've done this better than anyone else for more than 155 years. Discover your potential with a career at Northwestern Mutual:
- One of the "World's Most Admired" life insurance company according to FORTUNE® magazine's 2012 annual survey.
- High customer satisfaction - evidenced by a persistency rate of 96% for life insurance in force.
- Northwestern Mutual's financial strength ratings are unsurpassed in the industry.
- Diversity Employers Top 100 Employer for the class of 2011. As a mutual company, we focus on our clients' long-term needs and best interests.
We hire the best and brightest and encourage innovation and thought leadership through an environment of limitless opportunities.
- The incumbent will be an employee of Northwestern Mutual’s Corporate Home Office in Franklin, WI.
- The incumbent must have the ability to travel frequently to cover the New York/New Jersey territory including all of New York and New Jersey.
- The incumbent will work from home and must live within 45 minutes of New York City and within 45 minutes of a major airport hub within the designated territory.
- The incumbent must be available to travel as needed throughout the territory. This may include traveling on multiple weekdays each week and overnight travel. On occasion, the position may require handling cases on weekends or evenings and may require travel to other territories around the country to back-up fellow team members.
- Travels as needed to personally investigate and analyze the most complex contestable and non-contestable Disability Income, Life and Life Premium Waiver claims.
- Interprets, analyzes and identifies pertinent facts, redirecting handling on the spot as necessary to provide all of the facts required to assure handling in accordance with policy provisions, state regulations, and claims procedures and standards.
- Consults with the Assistant Director, Disability Income Benefits/Long Term Care Claims, Special Investigators and the Division Analysts, Specialists or Consultants to ensure appropriate and timely handling.
- In select cases, negotiates to resolve difficult or questionable claims with insureds, policyowners and/or their legal representatives.
- Handles complex field investigations as a representative of the company for Compliance, Law, Long Term Care and other areas of the company, as needed.
- Acts as a detached representative of the Special Investigations Unit.
- Bachelor’s Degree or equivalent work experience.
- Minimum of 5-7 years of extensive investigative and/or complex disability or life claims handling experience demonstrating analytical ability, independent decision making and sound judgment.
- Excellent written and oral communication skills including the ability to handle complex interpersonal situations.
- Superior organizational skills.
- Strong interpersonal skills, self awareness and the ability to easily establish rapport with diverse individuals.
- Demonstrated ability to work both independently and collaboratively within a team, set priorities and complete assignments in a timely manner.
- Satisfactory driving record.
- Excellent personal financial management and credit history.
How to Apply:
Interested candidates should apply via our company website at: www.northwesternmutual.com; click on the 'careers' tab, select 'corporate opportunities' and apply to job number 14-0298 Field Benefit Consultant.
Company: Pacific Life
Location: Aliso Viejo, CA
Job Title: Claims Coordinator
About Pacific Life
Pacific Life offers life insurance, annuities, and mutual funds, along with a variety of investment products and services, all of which provide The Power to Help You Succeed.
Headquartered in Newport Beach, CA, Pacific Life is a Fortune 500 company with approximately 2700 employees. We pride ourselves on providing an innovative work environment which is highly challenging and exceptionally rewarding. We firmly believe each employee plays a part in our continued growth and success.
Currently, we are seeking a talented Life Claims Coordinator to join the Life Insurance Division in Aliso Viejo. The Life Insurance Division works with financial and insurance professionals to give families and businesses the life insurance coverage needed to help meet important financial protection, wealth accumulation, and wealth preservation goals.
Perform a variety of specialized and analytical tasks related to individual life claim administration such as the examination of death claims, disability benefit, waiver of cost/premium, Chronic Illness, PremierCare and accelerated living benefit claims.
- Process, approve, deny or otherwise direct handling of life and living benefit claim requests, including contestable and otherwise complex claims
- Process in the appropriate Life Division system; job performance must meet department standards for work prioritization, productivity, quality and timeliness, as well as adhere to any claims related regulatory requirements.
- Perform quality review by auditing completed Inforce work; providing training and processing guidance to less experienced team members
- Assess pending work volumes, prioritizing and coordinating outstanding work items for completion
- Correspond and communicate effectively with claimants, attorneys, life insurance producers, senior team members, and internal customers and management for the purpose of coordinating case work and resolving issues relevant to effective claims administration
- Collaborates with other areas and third party vendors to resolve complex situations and discretionary cases
- Identify, understand and ensure that your actions, behaviors and decisions are consistent with the Client Services department, Life Insurance division and Pacific Life Mission & Vision
- Assist and contribute to team meetings and special projects related to Life Division
Factors for Success:
- Demonstrated ability to clearly communicate (written/verbal)
- Ability to work with multiple computer systems concurrently
- Ability to manage multiple priorities, utilizing strong analytical/decision making skills
- Ability to process client requests which require consideration of industry regulations, legal liability and moderate risk of financial impact
- General business/office skills, such as basic Microsoft Word, Excel, and Outlook, fax, and photocopier
- Basic math reasoning skills
- College degree or equivalent combination of education and experience
- 4 - 5 Individual Life Claim Experience required
- Life Claim insurance experience required.
Join the Pacific Life team and watch your career grow! We offer competitive pay/ bonus program and a comprehensive benefits package including:
- Medical/dental coverage
- TWO retirement plans: 401k retirement plan with company match and company-paid Retirement Benefit Account where company contributes 4% up to taxable wage base and 8% over to IRS compensation maximum
- Vacation/holiday pay
- Medical and dependent care flexible spending accounts
- And much more!
For more information, and to apply online, please visit our web site: www.pacificlife.com
Pacific Life Insurance Company is an Equal Opportunity /Affirmative Action Employer, M/F/D/V
If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact a Human Resources Representative at Pacific Life Insurance Company.
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
All postings will remain for 60 days unless otherwise noted
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