Ameritas · 1 day ago

Sr. Life Claims Examiner

Lincoln, OH

Full-time

Remote

Entry, Mid Level

1+ years exp

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Responsibilities

Evaluates and authorizes disposition of complex claims.

Obtains and analyzes medical records and financial documents.

Assists in analyzing and recommending disposition of contestable and complex claims where liability is questionable with limits up to $350,000.

Initiates and monitors medical reviews, independent medical examinations, surveillance, and financial reviews.

Corresponds with policyholders, attorneys, medical facilities, reinsurers, outside vendors, and insured's employer.

Interacts and requests formal written opinions from Legal and Medical/Underwriting departments.

Makes decisions on evaluation of claims using judgment, experience, and collaboration with senior associates.

Assists with recoveries from reinsurance carriers.

Performs all claims processing support functions.

Additional duties as required.

Qualification

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Claims evaluationMedical record analysisFinancial document analysisLife insurance experienceInsurance claim experienceIndependent medical examinationsCommunication with stakeholders