Job Description
The Claims Specialist will provide excellent customer service to Penn Mutual beneficiaries and financial professionals. S/he will adjudicate Life, Annuity and RPS death claims, validate beneficiary designations, and process payments within the documented procedures and regulatory guidelines. Create collaborative relationships with team members, financial professionals and beneficiaries. Performs system/acceptance testing for enhancements to administrative and corporate systems.
We’ve embraced a flexible, hybrid approach to work. Based on your role and personal preference, we empower you to choose where you work best. This model allows you to balance your life and bring your whole self to work.
Responsibilities
- Adjudicate Life, Annuity, Repetitive Payment (RPS), Waiver and Accelerated Death claims within the established speed of service and accuracy guidelines.
- Process Disability claims; analyzing medical records, communicate with claimants, physicians and medical providers, make eligibility recommendations and assist with complex disability claim calls.
- Produces accurate payments, with attention to detail and adherence to claim regulations, including completion of accurate death claim interest calculations.
- Processes financial and non-financial transactions and document records with consistent quality and attention to detail.
- Applies established procedures and regulatory guidelines to determine if requests are in ‘good order’.
- Navigates multiple administration systems as well as our workflow and imaging tools to gain and document needed information.
- Escalates unusual situations, investigates suspected fraud and contestable claims as assigned by Management. Professional interaction with the Legal Department.
- Understands and assists with Audits.
- Assists with in-bound calls from our financial professionals, clients and beneficiaries on an “as needed” basis providing prompt, courteous service.
- Assists with identifying trends and suggests improvements to processes, procedures and/or training.
- Perform peer review of cases over $250,000 in benefit; settle claims over 1M
- Assists with the creation of process/procedure documentation to include letter templates
- Creates collaborative relationships with team members, financial professionals and beneficiaries
- Takes ownership of professional growth and development
- Complies with all company procedures
- Remains current in profession and industry trends
- Successfully completes regulatory and job training requirements
- Performs other duties as assigned
Skills And Abilities
- A customer service attitude that translates professionalism, confidence, and empathy
- Knowledge of medical conditions related to disability processing a plus
- Ability to think like the customer and respond with the level of urgency and professionalism expected
- Creative, energetic and self-motivated with the ability to operate effectively in a self-directed and team environment. Initiative to get the whole job done and take ownership of each customer interaction
- Strong math skills
- Excellent verbal and written communication skills
- Ability to disseminate and learn complex information in a short period of time
- Efficient and accurate use of a computer for data entry, documentation, and navigation within multiple systems
- Ability to multi-task and quickly navigate multiple resources while maintaining quality
- Willingness to work various schedules and adapt to a changing work environment
- Willingness to learn all lines of Penn Mutual’s business, including life insurance, annuities, and RPS
- Proven ability to work under pressure and meet deadlines
- Ability to make a positive contribution as demonstrated by learning new skills and making suggestions for process/procedure improvement
- Ability to work with others in a collaborative team environment
- Effectively communicate the needs of the team in meetings by providing input and recommendations, making formal presentations as needed.
- Independent problem solver with the ability to use sound business judgment to identify potential problems and recommend solutions.
Education
Experience
- 5-7 Years of related work experience Required
- ALHC designation Preferred
- International Claim Association: Associate, Life & Health Claims Preferred
Base Salary Range - $60,000 - $79,500
Penn Mutual helps people become stronger. Our expertly crafted life insurance is vital to long-term financial health and strengthens people’s ability to enjoy every day. Working with our trusted network of financial professionals, we take the long view, building customized solutions for individuals, their families, and their businesses. We support our financial professionals with retirement and investment services through our wholly owned subsidiary, Hornor, Townsend & Kent, LLC, member FINRA/SIPC.
Penn Mutual is committed to Equal Employment Opportunity (EEO). We provide employment and advancement opportunities to all qualified applicants and associates, according to applicable laws. This is reflected in our practices for hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment, compensation, selection or training, and all other terms and conditions of employment. All employment-related decisions and practices are free from unlawful discrimination. This includes: race, creed, color, national origin, ancestry, citizenship age, gender (including pregnancy), sexual orientation, gender identity or expression, domestic partnership or civil union status, marital status, genetic information, disability, religious observance or practice, liability, veteran status or any other classification protected under applicable law.
