Claims Examiner II – Accident & Health
| Company | American International Group |
|---|---|
| Location | Lenexa, KS, USA |
| Salary | $Not Provided – $Not Provided |
| Type | Full-Time |
| Degrees | |
| Experience Level | Junior, Mid Level |
Requirements
- A highly organized individual with ability to work in a high pace, team oriented environment.
- Insurance claims experience of at least 1+ year(s) with exposure to Accident and Health claims, which include sickness and bodily type injury claims or any related experience handling complex risks.
- Superior customer services skills and ability to help manage response timelines and reporting requirements, such as under performance guarantees.
- Above average computer and organizational skills.
- Excellent written and verbal communication skills with an ability to handle customer appeals.
- Ability to read and interpret insurance policies and act as liaison with Underwriting as needed.
- Ability to coach and develop others.
- Accident and Health State Adjuster licenses a plus, and job contingent after hire.
- Bilingual (Spanish) a plus.
Responsibilities
- Handle Accident & Health claims as part of the A&H team, handling claims such as A&D, permanent and total disability, critical illness and/or accident and sickness, medical evacuation, trip cancellation, out of country medical etc., including key accounts that may have performance guarantees. Confirm coverage of claims by reviewing policies and documents submitted in support of claims; analyze coverage and communicate coverage position.
- Conduct, coordinate, and direct investigation into loss facts; Determine eligibility of claims and amounts owed under the terms of the contract.
- Recognize and pursue subrogation where warranted and make appropriate Risk and Fraud referrals.
- Increased responsibility with an expectation of managing higher claims volumes and assist manager with customer escalations and file audits as needed.
- Assist with team development and guidance.
- Innovative mindset to help drive process improvement.
- Other duties as assigned.
Preferred Qualifications
- Accident and Health State Adjuster licenses a plus, and job contingent after hire.
- Bilingual (Spanish) a plus.