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Pan-American Life Insurance Group · 1 day ago

Claims Associate

New Orleans, LA

Full-time

Onsite

Entry Level

1+ years exp

Pan-American Life Insurance Group (PALIG) is seeking a Claims Associate who will be one of the primary interfaces with our beneficiaries requiring utmost professionalism in interacting with individuals during the claims process. The Claims Associate will handle critical administrative duties related to time sensitive claim processing.

Financial ServicesInsurance

Responsibilities

Effectively communicates with customers

Conveys empathy and maintains a high level of professionalism

Responsible for responding to client inquiries received via phone, mail, or email

Receive and incur new death death claims

Review policy record, document appropriate workflow and policy administration systems, prepare and release generic claim requirement packets

Review pending claims and follow up regularly with beneficiaries to obtain claim documents

Assist the Claims Examiner in obtaining any other supporting documentation necessary to review and process the claim, including but not limited to medical records

Prepare and mail all final and closing file notifications and work with Management to identify possible movement to unclaimed or abandoned property

Receive all claim documentation, update all relevant systems with required information/documentation, request pending claim documentation

Review and categorize all claim documentation according to established procedures and ensure all claim documentation is properly archived to imaging systems (PALIG)

Receive and respond to policy locator requests

Receive and prepare requests for beneficiary verifications, update appropriate systems as needed

Receive and process change of beneficiary requests

Receive and incur new disability claims; communicate with third party administrator and reinsurers as needed

Receive daily disability payments reports, review, and process in system

Maintain proper documentation of processed daily disability claim payments, review against daily payment reports to ensure accuracy

Ensure all insured records from TPA reconcile with PALIC records, take appropriate action if discrepancies are found

Review monthly report from TPA to ensure new claims and take appropriate action in systems for closed claims

Review all incoming Life Waiver Claim documentation and forward to Claims Examiner for evaluation

Prepare all correspondence and mail all relevant forms for all continuation of life waiver benefit claims. Review records when received and forward to claims Examiners for final determination

Assist Claims Examiner with all life waiver claims related process including but not limited to ordering medical records when applicable

Download and review the weekly and quarterly report receiving from our third party administrator

Identify potential death claims and validate death of insured. Update all necessary system application to initiate the claims’ process

Identify possible owner deaths and validate. Update all necessary system applications to initiate the process of updating the ownership under the contract stipulations

Identify possible deceased Settlement Contracts beneficiaries and validate. Update all necessary system applications to initiate the final payment by the Financial Services Dept

Quarterly upload and review of data for validation against the SSA DMF

Qualification

Claims ProcessingCustomer ServiceBasic AccountingAttention to DetailProblem SolvingOrganization/PlanningWriting/ReadingComputer ApplicationsTeamworkFlexibility

Required

High school diploma or equivalent

1 year of relevant work experience

Customer Service: Knowledge of principles and processes for providing customer services, such as needs assessment, meeting quality standards for services and evaluating service delivery satisfaction

Writing/Reading: Understands documents and applies the information to work situations; conveys ideas and facts concisely and accurately in writing

Attention to Detail: Accomplishes tasks by focusing on all areas involved; ensures all associated processes and tasks are completed; vigilantly watches over/checks processes and tasks to ensure accuracy

Problem Solving Skills: Analyzes a situation by gathering and organizing information; assesses cause and effect relationships and recommends potential solutions

Flexibility: Maintains an open mind; performs a wide variety of tasks and changes focus as demands change; transitions smoothly from one task to another as customer demands change

Organization/Planning: Plans and prioritizes tasks to ensure work is completed accurately and timely

Teamwork: Works with others to get results; responds positively to instructions and procedures; shares information with everyone on a project

Computer Applications: Remains current on knowledge of applicable computer applications and basic computer functions

Basic Accounting knowledge