Investigative Claims Examiner job at F&G - Fidelity & Guaranty Life Insurance Company in US National
Title: Investigative Claims Examiner
Location: Remote US
Job Description:
This position is responsible for the adjudication of contestable life and disability claims, accelerated benefit
claims, critical illness claims, and complex incontestable life, annuity and disability claim. This position does
not have direct supervisory responsibilities.
Duties and Responsibilities
Investigate, in a thorough, timely, and cost-effective manner, all contestable life, disability, annuity and complex incontestable claims to determine the extent of liability and the appropriateness of payment or denial of the claim
Process payment, perform payment reviews and quality, and denial of claims and rescissions of policies
Provide leadership, help build teamwork, and offer mentoring to other members of the claims staff
Handle claims escalations and provide response via phone, email, and/or outbound written correspondence
May serve as conduit between team and legal and compliance department, vendors, and internal departments
Perform quality audits and call monitoring, document results, and provide direct feedback and training to other members of the claim staff
Maintain claim registers for accurate financial reporting of pending, paid, and denied claims
Maintain complete and accurate documentation of claim files
Support company or team initiatives either directly or indirectly.
Experience and Education Requirements
Bachelor's degree or equivalent experience required
3+ years of experience investigating contestable life and/or disability claims
LOMA and/or ICA coursework preferred.
Skills and Abilities
Understands how the functional units interact with each other; recognizes business changes within coverage area and the impact
Quickly processes information and develops solutions in real-time, with practical, measurable business benefits (i.e., thinks on one’s feet)
Proactively identifies opportunities to serve the customer
Works with other colleagues and leaders deliver Operations strategy
Reads a wide range of audiences and situations and quickly adjusts communication style accordingly; selects the appropriate communication channel and tone to deliver tough messages
Identifies opportunities to use innovative processes
Ability to coach and mentor colleagues on digital techniques and accelerators used at F&G
Seeks opportunities to cultivate relationships with established contacts in their network
Provides guidance on what information to gather to achieve business objectives and how to efficiently obtain information that is not easily available
Seeks challenging assignments and projects
Understands and demonstrates commitment to the departmental vision, strategy, change initiatives and goals
Proactively identifies opportunities to improve department performance and escalates ideas to leadership
Monitors, measures, and assesses processes to determine areas of improvement; identifies and eliminates operational waste
Understands data and communicates the meaning to managers and executives
Owns responsibility for timely production of deliverables
Supports with monitoring of vendor performance; identifies and escalates issues; develops processes to maximize vendor performance
Demonstrates ability to develop solutions in real time with practical, measurable business benefits; supports long term business unit or department planning
Maintains industry regulatory knowledge.
Other Requirements:
Perform other functions, duties and projects as assigned
Regular and punctual attendance
Some travel may be required (less than 10%)
Additional Information
Work Environments
F&G believes in an employee-centric flexible environment, which is why we offer the ability for in-office, hybrid and remote work arrangements. During the hiring process, you'll work with your leader to decide what works best for your role.
Apply Now
Apply Now
Location: Remote US
Job Description:
This position is responsible for the adjudication of contestable life and disability claims, accelerated benefit
claims, critical illness claims, and complex incontestable life, annuity and disability claim. This position does
not have direct supervisory responsibilities.
Duties and Responsibilities
Investigate, in a thorough, timely, and cost-effective manner, all contestable life, disability, annuity and complex incontestable claims to determine the extent of liability and the appropriateness of payment or denial of the claim
Process payment, perform payment reviews and quality, and denial of claims and rescissions of policies
Provide leadership, help build teamwork, and offer mentoring to other members of the claims staff
Handle claims escalations and provide response via phone, email, and/or outbound written correspondence
May serve as conduit between team and legal and compliance department, vendors, and internal departments
Perform quality audits and call monitoring, document results, and provide direct feedback and training to other members of the claim staff
Maintain claim registers for accurate financial reporting of pending, paid, and denied claims
Maintain complete and accurate documentation of claim files
Support company or team initiatives either directly or indirectly.
Experience and Education Requirements
Bachelor's degree or equivalent experience required
3+ years of experience investigating contestable life and/or disability claims
LOMA and/or ICA coursework preferred.
Skills and Abilities
Understands how the functional units interact with each other; recognizes business changes within coverage area and the impact
Quickly processes information and develops solutions in real-time, with practical, measurable business benefits (i.e., thinks on one’s feet)
Proactively identifies opportunities to serve the customer
Works with other colleagues and leaders deliver Operations strategy
Reads a wide range of audiences and situations and quickly adjusts communication style accordingly; selects the appropriate communication channel and tone to deliver tough messages
Identifies opportunities to use innovative processes
Ability to coach and mentor colleagues on digital techniques and accelerators used at F&G
Seeks opportunities to cultivate relationships with established contacts in their network
Provides guidance on what information to gather to achieve business objectives and how to efficiently obtain information that is not easily available
Seeks challenging assignments and projects
Understands and demonstrates commitment to the departmental vision, strategy, change initiatives and goals
Proactively identifies opportunities to improve department performance and escalates ideas to leadership
Monitors, measures, and assesses processes to determine areas of improvement; identifies and eliminates operational waste
Understands data and communicates the meaning to managers and executives
Owns responsibility for timely production of deliverables
Supports with monitoring of vendor performance; identifies and escalates issues; develops processes to maximize vendor performance
Demonstrates ability to develop solutions in real time with practical, measurable business benefits; supports long term business unit or department planning
Maintains industry regulatory knowledge.
Other Requirements:
Perform other functions, duties and projects as assigned
Regular and punctual attendance
Some travel may be required (less than 10%)
Additional Information
Work Environments
F&G believes in an employee-centric flexible environment, which is why we offer the ability for in-office, hybrid and remote work arrangements. During the hiring process, you'll work with your leader to decide what works best for your role.
Apply Now
Apply Now