This job has expired, please see additional jobs below
Claims Specialist
Ameritas Life Insurance Corp
Cincinnati, OH, United States
Job Details - this job has expired, please see similar jobs below
Ameritas Life Insurance Corp is hiring a Disability Income Claims Specialist to drive the business by evaluating, analyzing and adjudicating Individual Disability Income claims in accordance with the Fair Claims Practices Act and compliance with State and Federal Laws and Regulations, while providing timely and accurate service to our clients, agents, and brokers.
Essential Job Functions
• Communicates, both written and oral, with agents, policyholders, attorneys, employers, medical facilities and State Insurance Departments
• Obtains and reviews medical records and reports
• Review and analyzes financial documentation
• Maintains claims support operations staff by recruiting, selecting, orienting and training employees
• Knowledge of all current and previously issued contracts including State variations, enhancements and/or liberalizations
• Responsible for evaluating new claims (both contestable and non), which may include DI, Treatment of Injury, Cancer, Hospital Confinement, Maximum Medical Improvement and Waiver of Premium. Also, the evaluation and continual review of ongoing claims based on appropriate guidelines or Fair Claims Practices.
• Maintain correspondence with Reinsurers, outside vendors, other insurance companies, and Insured's employer(s).
• Coordinate medical and psychological reviews, Independent Medical Examinations, Surveillances, and Financial reviews.
• Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; and participating in professional societies
• Works closely with the following internal departments: Law, Treasury, New Business, Billing, Actuarial, Reinsurance, and Medical/Underwriting
• Required to have expertise in Claims Tracking, and working knowledge of the following systems: POS, CICP, LIDP and the Internet
• Coordination with the Field Representatives on claimant visits and information gathering
• Completes special projects as assigned by manager
• Required to conform to corporate and department confidentiality guidelines
• Provides prompt, accurate responses to telephone inquiries; receives and responds to ACD calls
• Required to participate in SIU as needed
• Required to attend annual anti-fraud and Fair Claims Practices training
• Protects operations by keeping claims information confidential
• Involvement in depositions, court appearances and negotiations regarding settlement options
• May be required to serve as backup to Division Manager
Qualifications
• College Degree preferred or related business background
• Senior Examiner for at least two years - most preferably in DI
• ICA and/or LOMA preferred
• Excellent written and oral communications
• Excellent spelling and grammar
• Willing to work independently and as an effective member of a team
• High level of self-confidence and decision making ability
• Excellent planning, analytical and organizational skills
• Substantial keyboarding
This position could also be filled at the lower levels of Examiner or Senior Examiner.
We are Ameritas: proud to say we're in the business of fulfilling life.