Associate - Insurance - Life 5A
Core
Review and assess employee benefit claims to determine eligibility based on policy terms, gathering documentation and analyzing medical records and employment history.
Role type
Associate claims analyst (life insurance)
Builds
Accurate and timely processing of employee benefit claims
Domain
Insurance / Life Insurance
Deliverable
client delivery
Required skills
Critical Thinking, Fraud Management, Insurance, Life Insurance, Quality Management
Preferred skills
Associate in Claims (AIC), Certified Financial Analyst (CFA), Certified Fraud Examiner (CFE), Chartered Property Casualty Underwriter (CPCU), Fellow of the Institute of Actuaries (FIA)
Technologies
Workflow systems
Responsibilities
Review and assess employee benefit claims to determine eligibility based on policy terms and conditions; Gather necessary documentation from claimants, medical professionals, and other relevant sources to support the claim evaluation process; Analyze medical records, employment history, and other pertinent information to make informed decisions; Communicate with claimants to provide updates on their claim status and request additional information when needed; Collaborate with healthcare providers, employers, and other stakeholders to ensure accurate and timely processing of claims; Conduct regular audits of claims files to ensure accuracy, completeness, and adherence to standards.
Seniority
Associate