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Claims Examiner/Process Delivery Specialist
Provide prompt and accurate service involving the payment and or research of incontestable death claims. Respond to customer inquiries orally or through written communication.
Process and assure correct settlement of routine death claims up to $500,000.00.
Determine family coverage and issue endorsements accordingly.
Calculate settlement adjustments as necessary.
Handle telephone calls, emails and letter inquiries.
Provide accurate claim and/or policy status, beneficiary information and settlement explanations to claimants, funeral homes and local offices.
Handle special projects as assigned.
Strong analytical and critical thinking skills are needed, good oral and written communication and excellent customer service skills. Will have frequent contact with claimant’s, attorneys, funeral homes, local offices, and other departments answering detailed questions and providing claim information either orally or through written communication.
Strong computer skills including Word and minimum of 40 WPM typing/keying is required. Experience with AGNIS/VFlex, AWD and the claims system preferred.
Requires detailed analysis of a variety of information from various sources including policy provisions, proofs of death, assignments, legal documents, policy status and policy histories.
Ability to use sound judgment and make decisions requiring good understanding of claims practices, procedures and state regulations.
Willingness to participate in education programs offered in house that will enhance skills.
Must be able to work overtime as needed.
Bachelor’s Degree is preferred; a high school education is a minimum requirement or equivalent claims experience in the insurance industry preferred. Requires knowledge of claim procedures, policy contracts and provisions.