Descripción del trabajo

Process Specialist
Claims Examiner
Location: Des Moines, IA

In the role of Process Specialist, you will serve as a subject matter expert for the claim team in answering team member questions regarding case specifics and assisting with complicated cases. You will respond to phone and email inquiries related to claims and follow up on any outstanding requirements within a specified timeframe. You will maintain detailed, compliant, and accurate documentation of all claim activity and collaborate with the team to update procedures and develop new procedures as appropriate.

Responsibilities:

• Serve as an SME for claim team in answering team member questions regarding case specifics and assisting with complicated cases.
• Customer Service Experience – respond to phone and email inquiries related to claims.
• Follow up on any outstanding requirements within a specified timeframe.
• Maintain detailed, compliant, and accurate documentation of all claim activity.
• Collaborate with team to update procedures and develop new procedures as appropriate.
• Coordinate special projects as assigned.
• Training in new procedures.
• Perform quality reviews on claims/letters.

• High School Diploma or GED Equivalent. Will also consider three years of progressive experience in the specialty in lieu of every year of education.
• 2 years’ experience relevant to the job description

• Associate or bachelor’s degree
• 3 years’ experience analyzing life claims.
• Effective written and verbal communication skills
• Knowledge of the insurance industry or insurance products/procedures through a combination of experience and/or coursework
• Organizational and follow through skills.
• Sensitivity to service and quality
• Ability to work with confidential information.

• Serve as a SME for claim team in answering team member questions regarding case specifics and assisting with complicated cases.
• Customer Service Experience – respond to phone and email inquiries related to claims.
• Follow up on any outstanding requirements within a specified timeframe.
• Maintain detailed, compliant, and accurate documentation of all claim activity.
• Collaborate with team to update procedures and develop new procedures as appropriate.
• Coordinate special projects as assigned.
• Training on new procedures.
• Perform quality reviews on claims/letters.