Claims Specialist II Individual Life - Health (Hybrid)

Company: Protective Life Insurance Company
Location: Birmingham
Posted on: January 24, 2023

Job Description:

The work we do has an impact on millions of lives, and you can be a part of it.We help protect our customers against life's uncertainties. Regardless of where you work within the company, you'll be helping provide protection and peace of mind when our customers need it most.
The Customer Claims Specialist works in a team environment to process Life Insurance, Annuity and VUL claims. This position will handle calls from customers, agents, funeral homes, attorneys, etc. Excellent written and verbal communication skills are required. This position requires someone with excellent attention to details, critical thinking & organizational skills, time management, knowledge of Life Insurance, Annuities and VUL, above average computer keyboarding skills and a professional demeanor.Primary Job Functions

• Contact with teammates, management, and other departments.
• Requires tact, conflict resolution skills, and the knowledge and experience of the business to provide accurate and informative answers to customer's inquiries.
• Review and process claim within time goal required.
• Direct phone contact with beneficiaries and other parties.Work Experience, Education, Certification / Training Required
  • Strong background in customer service gained by at least 3 years' work or equivalent experience.
  • Strong background in the insurance industry gained by completion of the LOMA Level 1 or equivalent experience.
  • High School Diploma Knowledge, Skills and AbilitiesKnowledge, Skills and Abilities Required:
    • Process claims
    • Fully investigates all relevant claim issues, provides prompt payment and in full compliance with departmental procedures, Unfair Claims Practice regulations and in accordance with the terms of the insurance contract and applicable law
    • Consistently communicates status with all appropriate parties involved with the claim.
    • The Examiner is accountable for identifying and evaluating information required to adjudicate claims.
    • Answering calls - Answering telephone inquiries from backup ACD line concerning claim status, claim filing, reports of death, as well as communicating internally with other departments.
    • Handling of customer complaints from ACD line and document the information received and telephone conversation into the claim file.
    • Responsible for incoming and outgoing calls to claimants, Powers of Attorney, facilities and other person's or entities involved in the payment of a claim. Correspondence
    • Respond in writing to customer inquiries in accordance with regulations.
    • Review demand letters and responds within individual parameters and escalates as appropriate.
    • Research - Verifies policyholder information, policy effective dates, premium status and verification of claim eligibility.
    • Identifies the need for additional information.
    • Contacts appropriate source to obtain needed information.
    • Verifies beneficiary information and payment amount.
    • Approve - Approve claims according to the designated approval authority guidelines -Assist with Unclaimed Property process.
    • Reviews and analyze IRS Form W9 and Form W8.
    • Maintain claim file with proper level of documentation.
    • Maintain claim inventories within departmental, contractual and regulatory guidelines.
    • Has knowledge and is able to work simultaneously with multiple computer systems.
    • Able to complete moderately difficult mathematical calculations.
    • Strong customer service orientation and able to work with customers in a professional and empathetic manner
    • Have a strong sense of teamwork. Work harmoniously with peers within a team environment to accomplish both personal and team performance goals.
    • Participates as a team member for all system and new product initiatives. Ability to use independent initiative to seek answers to customer concerns. Ability to prioritize multiple tasks and meet deadlines.This position has availability of hybrid after 90 days and Full remote after 6 months pending on reaching metrics!
      Employee Benefits: We aim to protect our employees' wellbeing through a broad benefits offering. For example, we protect physical wellbeing through health, dental and vision insurance. We protect mental wellbeing through mental health benefits and an employee assistance program. We protect time away from work with a variety of paid time away benefits (e.g., paid time off, paid parental leave, short-term disability, and a cultural observance day). We protect financial wellbeing through contributions to healthcare accounts, a pension plan, and a 401(k) plan with Company matching. All employees are encouraged to protect their overall wellbeing by engaging in ProHealth Rewards, Protective's platform to improve wellbeing while earning cash rewards. Eligibility for certain benefits may vary by position in accordance with the terms of the Company's benefit plans.
      Diversity and Inclusion: At Protective, we are committed to providing an inclusive culture where all employees are able to fully contribute and thrive. Our goal is to grow and develop our people, attract diverse talent and support strong, diverse communities.
      We support diversity, equity, and inclusion by working to develop a culture of inclusion and belonging led by leaders who develop potential and embrace unique skills and abilities. Our aim is to create an equitable and accountable environment for all leaders and employees that will drive performance and impact business strategy. In this way, we can increase overall diversity for leadership roles and pipelines of talent by maturing our hiring practices, robust development opportunities and focus on retention of key talent.
      We are proud to be an equal opportunity employer committed to being inclusive and attracting, retaining, and growing the talents of a diverse and inclusive workforce.

Keywords: Protective Life Insurance Company, Birmingham , Claims Specialist II Individual Life - Health (Hybrid), Healthcare , Birmingham, Alabama