Claims Examiner reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Being a Claims Examiner studies reports prepared by adjusters and similar claims to determine the extent of insurance coverage and validity of the claim. Communicates with agents, claimants, and policy holders. Additionally, Claims Examiner determines settlement according to organization practices and procedures. May require a bachelor's degree. Typically reports to a supervisor or manager. The Claims Examiner work is closely managed. Works on projects/matters of limited complexity in a support role. To be a Claims Examiner typically requires 0-2 years of related experience. (Copyright 2024 Salary.com)
QUALIFICATIONS/REQUIREMENTS:
Bachelor’s degree in business or related field, or equivalent work experience.
Two years of practical life insurance claim payment or Customer Service experience.
Must be analytical, detail-oriented, and accurate.
General knowledge of accounting principles.
Effective communication skills to explain the facts and logic used to arrive at decisions in a way that the customer understands and compose clear, succinct descriptions when posting files and drafting correspondence.
Personal computer skills including use of MS Office Suite products.
Regular and reliable attendance and punctuality is an essential function of this position
DUTIES/RESPONSIBILITIES:
Analyze life claims and determine their validity based on policy provisions, riders, waivers, operating procedure, and state regulations; determine whether additional data is necessary; calculate the life benefits payable and any interest due; insure that valid claims are reviewed and paid in a prompt and equitable manner or decline payment of benefits when loss is not covered under the terms and provisions of the policy.
Provide superior customer service to claimants or their representatives through written correspondence, telephone, and face-to-face contact in a courteous, tactful, and appropriate manner.
Prepare tax forms, state notice forms, and state consent forms when applicable.
Request reinsurance reimbursements and closely monitor outstanding reimbursement and request any payments due.
Compile and communicate production reports as directed by Department Manager.
Other duties as assigned by manager.
Kansas City Life Insurance Company is committed to equal employment opportunities for all individuals regardless of race, religion, color, sex, age, national origin, disability, or genetic information.
Job Type: Full-time
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Work Location: In person