Claims Analyst

About Armed Forces Benefit Association (AFBA) and 5Star Life

In 1947 AFBAemerged from the basement of the Pentagon to solve a critical need in support of the military. More than 75 years later our commitment to those who serve and to solving their unique problems remains core to everything we do. Founded to provide military members with a death benefit no one else would we continue to embrace our mission and deliver benefits tailored to the real-life needs of all who serve today including active duty National Guard and first responders. Providing protection to those who go in harms way we ensure survivor and other benefits are available to all who serve defend and protect our great nation no matter what. 5Star Life Insurance Company was founded in service and carry that mission today by committing to serve those who serve from underwriting benefits for military and first responder families to providing coverage to the employees that keep our communities running. Our commitment to our communities rather than the bottom line- drives our business.

We offer a flexible hybrid work environment allowing you to enjoy the best of both worlds with 3 days in the office and up to 2 days working remotely each week. This position is in Lincoln NE.

General Description

Be part of a dynamic forward-thinking Worksite Group Voluntary Benefits team focused on providing an elevated client experience and comprehensive portfolio of life and supplemental health products striving to deliver total health and wellbeing to employer groups and their employees.

The Claims Analyst is an operations and sales support role responsible for managing beneficiary and group relationships at point of claim. This position will be supporting the beneficiary in understanding what is needed to complete a claim supporting an employer or service provider in understanding the claims provisions of their coverage along with being the communication point person with vendors.

Major responsibilities:

1. Claims Intake and Communication Management
   Handle incoming claim-related inquiries from brokers employer groups service providers and beneficiaries ensuring clear communication of requirements and next steps.
2. Claims Adjudication and Documentation
   Review and adjudicate voluntary health and wellness claims in accordance with contract provisions and benefit guidelines ensuring accuracy and compliance.
3. Stakeholder Relationship Building
   Build and maintain proactive relationships with internal teams brokers and employer groups to support claims processing and provide group claims experience reporting for renewals.
4. Process Improvement and Project Support
   Participate in process reviews and support initiatives related to new product implementation system troubleshooting and trend identification to enhance operational efficiency.
5. Cross-Functional Collaboration and Support
   Collaborate with Account Management Case Managers and Home Office Life Claims to ensure seamless communication and support across related functional areas.

Education Licensure Certification and Experience

• Associates degree or equivalent related work experience
• 3 years work experience preferred

Knowledge Skills and Abilities

• Self-motivated you are a go-getter minor hurdles do not prevent you from achieving your objectives
• Strong written and verbal communication skills you are a good empathetic listener clearly articulate your thoughts and are very persuasive
• Ability to read and understand Group Policy language and benefits
• Ability to understand Current Procedural Terminology (CPT) medical codes
• Organized you easily prioritize to maximize your efforts
• Computer skills you are proficient with Microsoft Office mainframe system and using an imaging system
• Life Accident Hospital Indemnity and Critical Illness product and claims proficiency
• Ability to guide conversations and use appropriate words and tone when dealing with difficult situations while maintaining a professional demeanor
• Strong attention to detail
• Forward thinking with innovation in mind
• Flexibility in adapting to changes in systems procedures and guidelines
• Demonstrates complete adherence to privacy laws and company privacy guidelines and appropriate level of concern for the safeguarding all client information
• Believe in teamwork
• Ability to solve problems and react quickly in case of any urgent situations
• A helpful and supportive nature
• Develop and maintain a positive work environment
• Practice good work ethics and be able to lead by example

About 5Star Life Insurance Company

5Star Life Insurance Company (5Star Life) is the primary underwriter of the Armed Forces Benefit Association (AFBA) member policies and is also a growing provider of group and worksite voluntary products. Its business model enables 5Star Life to serve the needs of a diverse clientele as an insurance advisor to individuals and organizations and as a trusted partner to brokers. Headquartered in Alexandria Virginia 5Star Life is currently licensed in 49 states the District of Columbia Puerto Rico the U.S. Virgin Islands Guam and American Samoa.

Acknowledgement

This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employee(s) will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments.

Essential duties and responsibilities are subject to possible modification to reasonably accommodate individuals with disabilities. This document does not create an employment contract implied or otherwise other than an at will relationship.

Benefits we offer:

• health insurance (medical dental and vision)
• flexible spending accounts (medical and dependent care)
• 401k plan with generous employer match
• paid time off
• paid holidays (12)
• life insurance
• short- and long-term disability insurance
• employee assistance program
• professional development & tuition reimbursement
• career growth opportunities
• on-site gym and locker rooms (Alexandria VA office only)
• friendly collaborative culture

Qualified people of all races ethnicities ages sex genders sexual orientations national origins gender identities marital status religions veterans statuses disabilities and any other protected classes are strongly encouraged to apply. As an equal opportunity workplace we are committed to creating an inclusive environment for all employees. AFBA and 5Star Life Insurance Company endeavors to make reasonable accommodations to the known physical or mental limitations of qualified applicants with a disability unless the accommodation would impose an undue hardship on the operation of our business. If an applicant believes they require such assistance to complete the application or to participate in an interview or has any questions or concerns they should contactHuman Resources ().EEO is the Law (Link to external DOL site). AFBA and 5Star Life Insurance Company is an Equal Opportunity Employer and an E-Verify Employer.