Claims Adjudicator

This is a fully remote position, open to applicants in Wisconsin.

📋 Description

• Adjudicate claims accurately while meeting established service goals.

• Adhere to documented processing procedures.

• Confirm receipt of appropriate forms as per state regulations.

• Enter and process claims for whole life, term life, universal life, interest-sensitive, acquisition preneed, final expense, preneed, trust, Texas preneed, annuity, contestable, and rider claims.

• Reconcile Texas preneed claims accurately and verify file documentation.

• Calculate cost basis on basic annuity claims with precision.

• Follow up on claims in writing within the time frames mandated by state regulations.

• Provide telephonic support for claims-related inquiries and correspondence.

• Communicate with empathy to policyholders, agents, funeral directors, beneficiaries, and other customers through verbal, written, and email interactions.

• Reach out to agents, funeral homes, beneficiaries, and other customers to gather missing information.

• Prepare correspondence for all stages of the claims process and customer inquiries.

• Investigate insured status and utilize databases to confirm information.

• Update spreadsheets and document findings accurately.

• Engage in group decision-making and offer support to team members.

• Manage personal time off, breaks, and lunches to ensure adequate team coverage.

• Assist in maintaining team standards and achieving goals.

• Investigate ambiguous issues, identify root causes, propose alternatives, resolve challenges, and escalate issues with recommendations.

• Complete assigned projects, tasks, and milestones by the designated due dates.

• Perform other related duties as assigned or required.

⛳️ Requirements

• Minimum: High School diploma or GED.

• One year of claims processing experience or equivalent business background.

• Intermediate understanding of NGL and acquisition products and procedures.

• Proficient oral and written communication abilities.

• General knowledge of PC and office machinery.

• Typing speed of at least 45 words per minute and 5,500 alphanumeric keystrokes per hour.

• Basic accounting skills knowledge.

• Capability to work collaboratively in a team setting.

• Highly organized and detail-oriented.

• Ability to conduct quick searches on the Internet and other databases.

• Preferred: Two years of customer service or experience in insurance/financial sectors.

• Preferred: LOMA Level I Certificate.

• Preferred: LOMA ACS.

• Preferred: Wisconsin Preneed Certification.

🏝️ Benefits

• 20 days of Paid Time Off, increasing to 25 days after 5 years.

• 11 Paid Holidays (10 company holidays and 1 personal holiday of your choice).

• Health care, dental, and vision insurance plans.

• Up to $1,500 (Family) or $1,000 (Single) annually contributed towards a Health Savings Account.

• Annual bonus based on company performance.

• Paid Parental Leave.

• 401(k) matching contributions up to 9%.

• Paid Sabbatical after 8 years of service.

• Paid Volunteer Time.

• Education Assistance Program.

• Employee Recognition Program.

• Employee Resource Groups.

• Opportunities for professional and personal development.

• Flexible work environment with options for fully remote, hybrid, or onsite work where available.

• Comprehensive Total Rewards package.

• Reasonable accommodations for qualified individuals with disabilities.