Group Life Claims Examiner
Group Life Claims Examiner
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Job Description
At Equitable our power is in our people. Were individuals from different cultures and backgrounds. Those differences make us stronger as a team and a force for good in our communities. Here youll work with dynamic individuals build your skills and unleash new ways of working and thinking. Are you ready to join an organization that will help unlock your potential
Equitable is seeking an influential and dynamic Claims Examiner to join our Group Life Claims organization. Claims Examiner is responsible for providing excellent customer service. You will be expected to utilize judgment and assess risk as you work with various business partners to render claim decisions.
Key Job Responsibilities
- Claims Management: Responsible for active case management of Life claims. Ensures claims are processed accurately within regulatory and company guidelines. Deliver an exceptional customer experience and ensure that customer commitments and deliverables are achieved. Review and interpret medical records utilizing resources as appropriate. Complete financial calculations specific to claims when applicable. Gain an understanding and working knowledge of the Equitable claim and other applicable systems policies procedures and contracts as well as regulatory and statutory requirements for claim adjudication. Apply contract/policy provisions to ensure accurate eligibility and liability decisions. Demonstrate and apply analytical and critical thinking skills.
- Client and Customer Relationships: Foster strong relationships with customers to understand their needs and ensure high levels of satisfaction. Addresses and resolves any customer challenges or concerns promptly. Communication via telephone email and text with employees employers attorneys and others. Provide timely and exceptional customer experience by paying appropriate claims accurately and timely responding to all inquiries and maintaining expected service and quality standards. Work within a fast-paced environment with tight deadlines and demonstrate the ability to balance multiple priorities. Work independently as well as within a team structure.
The base salary range for this position is $50000 - $60000. Actual base salaries vary based on skills experience and geographical addition to base pay Equitable provides compensation to reward performance with base salary increases spot bonuses and short-term incentive compensation opportunities. Eligibility for these programs depends on level and functional area of responsibility.
For eligible employees Equitable provides a full range of benefits. This includes medical dental vision a 401(k) plan and paid time off. For detailed descriptions of these benefits please reference the link below.
Equitable Pay and Benefits: Equitable Total Rewards Program
Required Qualifications
2 years prior experience managing Life claim products.
Excellent client relationship management skills.
Strong verbal written communication and presentation skills.
Comfortable dealing with complexity and ambiguity and able to explore multiple solutions.
Preferred Qualifications
Previous experience with FINEOS Claims software platform highly desired.
Exceptional customer service skills; Proven skills in positive and effective interaction with challenging customers.
Strong knowledge of regulatory requirements for Life claims.
Ability to handle sensitive information with confidentiality and professionalism.
Strong written and oral communication skills demonstrated in previous work experience.
Excellent organizational and time management skills with ability to multitask and prioritize deadlines.
Ability to manage multiple and changing priorities.
Detail oriented; able to analyze and research contract information.
Demonstrated ability to operate with a sense of urgency.
Experience in effectively meeting/exceeding individual professional expectations and team goals.
Demonstrated analytical and math skills.
Ability to exercise critical thinking skills risk management skills and sound judgment.
Ability to adapt problem solve quickly and communicate effective solutions.
High level of flexibility to adapt to the changing needs of the organization.
Self-motivated independent with proven ability to work effectively on a team and work with others in a highly collaborative team environment.
Continuous improvement mindset
A commitment to support a work environment that fosters diversity and inclusion.
Strong computer literacy and skills with the ability to work within multiple systems; proficiency with PC based programs such as Excel and Word.
Reliability and dependability throughout our extensive training program is crucial.
Skills
Analytical Thinking: Knowledge of techniques and tools that promote effective analysis; ability to determine the root cause of organizational problems and create alternative solutions that resolve these problems.
Customer Support Operations: Knowledge of customer support techniques tools technologies and best practices; ability to utilize all aspects of customer support operations to manage a call center.
Customer Support Systems: Knowledge of principles and techniques used in customer support and ability to use applications hardware software networking and the applications environment used for customer support.
Managing Multiple Priorities: Knowledge of effective self-management practices; ability to manage multiple concurrent objectives projects groups or activities making effective judgments as to prioritizing and time allocation.
Problem Solving: Knowledge of approaches tools techniques for recognizing anticipating and resolving organizational operational or process problems; ability to apply knowledge of problem solving appropriately to diverse situations.
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ABOUT EQUITABLE
At Equitable were a team committed to helping our clients secure their financial well-being so that they can pursue long and fulfilling lives.
We turn challenges into opportunities by thinking working and leading differently where everyone is a leader. We encourage every employee to leverage their unique talents to become a force for good at Equitable and in their local communities.
We are continuously investing in our people by offering growth internal mobility comprehensive compensation and benefits to support overall well-being flexibility and a culture of collaboration and teamwork.
We are looking for talented dedicated purposeful people who want to make an impact. Join Equitable and pursue a career with purpose.
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Equitable is committed to providing equal employment opportunities to our employees applicants and candidates based on individual qualifications without regard to race color religion gender gender identity and expression age national origin mental or physical disabilities sexual orientation veteran status genetic information or any other class protected by federal state and local laws.
NOTE: Equitable participates in the E-Verify program.
If reasonable accommodation is needed to participate in the job application or interview process or to perform the essential job functions of this position please contact Human Resources at or email us at.
Employment Type
Full-Time
