Senior Claims Examiner

SUMMARY

Under limited supervision, analyzes high dollar and complex claims. Verifies that the underlying cession(s) is eligible for reinsurance. Investigates early death and, foreign claims to identify undesirable trends in underwriting and/or claims adjudication practices that indicate a need for discussion with the client. Refers questionable claims to Underwriting, Medical and/or Legal departments when required. Assists in developing and implementing improvement processes for Claims. Handles retroceded claims that require manual processes.

PRINCIPAL DUTIES AND RESPONSIBILITIES-ESSENTIAL FUNCTIONS
1. Analyzes and processes high dollar, complex claims and early death claims;
verifies that the cession claimed was properly retroceded to the company and was properly established on the company’s administration system. Takes steps to resolve questions that arise from these claims.
2. Identifies undesirable underwriting and/or claim adjudication practices that require a need to elevate claim. Refers questionable claims to underwriting, medical and/or legal departments. May escalate issue to department vice president or sales department vice presidents.

3. Processes retroceded claims: assures that recoverables on large, complex retroceded claims are paid on a timely basis.

4. Identifies opportunities for investigation or application of “best practices” in client claim activities.

5. Verifies daily claim register by scanning the register to ensure accruals are reasonable, required fields are completed and that the register is free of obvious errors. Authorizes accrual vouchers.

6. Assists in training of new or junior associates.

7. Approves and authorizes cash disbursements up to prescribed limits. REQUIREMENTS


EDUCATION AND EXPERIENCERequired: Bachelor’s Degree or equivalent experience in insurance, reinsurance or financial services
6+ years life reinsurance claims or life insurance claims experience or 6 years combined experience in life claims and life underwriting
Preferred: Reinsurance industry knowledge

Progress toward FLMI, ALHC or other relevant professional accreditation

Qualified candidates, please contact:

Carole Long

877-434-6837 x15

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www.theheadhunter.com