Pan-American Life Insurance Group (PALIG) is seeking a Claims Associate to join the Global Life Claims Services Department. The Claims Associate is one of the primary interfaces with our beneficiaries and requires utmost professionalism in interacting with individuals during the claims process. The incumbent will be a primary team member handling critical administrative duties related to time sensitive claim processing and will be responsible for the following:
Receiving all notices of claims and incurring the claim for administration in the various system applications
Maintaining records for claims
Ensuring all claim documentation is properly organized and complete for auditing purposes
Serving as the liaison for records between the department and other relevant parties, including the various auditing agents, internal and external
Answering questions for claimants or others regarding coverage amounts and contingencies affecting payment allocation
Specializing in a specific field such as life and/or disability
Providing other assistance to examiners during investigations
Handling moderately complex issues and problems and referring more complex issues to higher-level staff
Possessing solid working knowledge of subject matter
This position is based out of our Oak Brook, IL, office and will require the incumbent to maintain, at first, an on-campus work schedule with the flexibility of a hybrid work opportunity eventually available.
ESSENTIAL FUNCTIONS:
Client Communication
Effectively communicate with customers
Convey empathy and maintain a high level of professionalism
Respond to client inquiries received via phone, mail, or email
Death Claims
Receive and incur new death claims
Review policy record, document appropriate workflow and policy administration systems, and prepare and release generic claim requirement packets
Review pending claims and follow up regularly with beneficiaries to obtain claim documents
Assist the Claims Examiner in obtaining any other supporting documentation necessary to review and process the claim, including, but not limited to, medical records
Prepare and mail all final and closing file notifications and work with Management to identify possible movement to unclaimed or abandoned property
Receive all claim documentation, update all relevant systems with required information/documentation, and request pending claim documentation
Review and categorize all claim documentation according to established procedures and ensure all claim documentation is properly archived to imaging systems (PALIG)
Receive and respond to policy locator requests
Disability Claims
Receive and incur new disability claims and communicate with third-party administrator (TPA) and reinsurers as needed
Receive daily disability payment reports and review and process in system
Maintain proper documentation of processed daily disability claim payments and review against daily payment reports to ensure accuracy
Ensure all insured records from TPA reconcile with PALIC records and take appropriate action if discrepancies are found
Review monthly report from TPA to ensure new claims and take appropriate action in systems for closed claims
Life Waiver Claims
Review all incoming life waiver claim documentation and forward to Claims Examiner for evaluation
Prepare all correspondence and mail all relevant forms for all continuation of life waiver benefit claims, and review records when received and forward to Claims Examiner for final determination
Assist Claims Examiner with all life waiver claims related processes, including, but not limited to, ordering medical records when applicable
Death Master File
Download and review the weekly and quarterly reports received from our third-party administrator
Identify potential death claims and validate death of insured and update all necessary system applications to initiate the claims process
Identify possible owner deaths and validate and update all necessary system applications to initiate the process of updating the ownership under the contract stipulations
Identify possible deceased settlement contracts beneficiaries and validate and update all necessary system applications to initiate the final payment by the Financial Services Department
Quarterly upload and review of data for validation against the SSA DMF
EDUCATION & EXPERIENCE:
High school diploma and one (1) year of relevant work experience required
Bachelor's Degree in related field and/or prior insurance industry experience preferred
KNOWLEDGE, SKILLS & ABILITIES:
Basic Accounting knowledge
Computer Applications: Remains current on knowledge of applicable computer applications and basic computer functions
Customer Service: Knowledge of principles and processes for providing customer services, such as needs assessment, meeting quality standards for services and evaluating service delivery satisfaction
Attention to Detail: Accomplishes tasks by focusing on all areas involved, ensures all associated processes and tasks are completed, and vigilantly watches over/checks processes and tasks to ensure accuracy
Flexibility: Maintains an open mind, performs a wide variety of tasks and changes focus as demands change, and transitions smoothly from one task to another as customer demands change
Organization/Planning: Plans and prioritizes tasks to ensure work is completed accurately and timely
Problem Solving Skills: Analyzes a situation by gathering and organizing information and assesses cause and effect relationships and recommends potential solutions
Teamwork: Works with others to get results, responds positively to instructions and procedures, and shares information with everyone on a project
Writing/Reading: Understands documents and applies the information to work situations and conveys ideas and facts concisely and accurately in writing
Pan-American Life Insurance Group Offers:
Comprehensive Compensation Packages (base & bonus)
A Comprehensive Benefits Package: Medical, Dental, 401K, Paid Time Off, and Tuition Reimbursement (etc.) are some examples. New hires are eligible for medical and dental coverage on the first of the month following 30 days of service.
Hybrid Work Opportunities
Who We Are:
Pan-American Life Insurance Group (PALIG) serves the life, accident, and health insurance needs of individuals and businesses in 49 U.S. states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands through its U.S. based member companies - Pan-American Life Insurance Company and Pan-American Assurance Company.
At Pan-American Life, our employees are our greatest asset. We are grateful for the collaborative efforts of our employees and partners, and for the confidence of the policyholders whose life and health we protect. It is through this long-standing commitment that Pan-American Life continues to succeed.
Pan-American Life is an Equal Opportunity Employer/Drug Free Workplace.
