Claims Representative - Individual Life

About the Role

This highly visible and critical role will work across myriad departments to ensure an efficient and effective process for individual life and AD&D claims. In this position, you will assess claims expertly, as well as evaluate client claim practices, perform reinsured client reviews, and conduct industry presentations.

Duties & Responsibilities

• Adjudicate complex, contestable claims, manage litigated cases, including processing compromised settlements, review high dollar, early duration claims to determine if the ceding company is following their guidelines, and make recommendations to the claims review committee
• Conduct expert individual life and AD&D insurance adjudication with internal standards and client response timelines
• Monitor coverage assessment including promptly identifying, addressing, and resolving coverage matters
• Monitor client claim results and provide business partners with accurate client information on a timely basis through claim analytics, data mining, and trend analysis

Skills & Experience

• 8-10 years of complex life claims experience required
• In-depth knowledge of direct insurance company claims operations
• Audit experience in some capacity required
• Reinsurance experience desirable
• Experience as an intermediate or senior individual claims assessor preferred
• Excellent presentation creation and delivery skills required

Compensation & Benefits

$95-$100,000 + full benefits package