Contestable Claims Analyst

The Contestable Analyst  reviews all aspects of a contestable claim and determines how to process. High exposure to a multitude of life claims is a norm for this position; Analyst  needs to be able to identify claim benefits in regards to the specific policy and operates on multiple claims systems.  The Analyst  has a checklist of items to review before the claim can progress for further processing. Some of these items include; performing a name search to see if the insured has additional coverage, reinstating a policy if it has already been removed from the system, requesting various types of letters, reviewing application date versus effective date of policy, reviewing Medical Information Bureau reports, requesting recordings of contact with insured, ordering medical records, and reviewing medical records. The Contestable Analyst  also determines if certain policies should be investigated by external third parties (i.e., RSB). Once the Analyst  makes a claim determination, they either proceed with paying the claim or rescind the claim. A Contestable Analyst  is responsible for keeping a claim moving through the processing procedures. Contestable Analyst  is in contact with agents, funeral homes, coroners, medical providers, and police departments to gather and confirm information in regards to the claim.

• Investigates all contestable life claims and processes in accordance with policy provisions and Company procedures.
• Processes claims on a multiple claims system.
• Contacts outside 3rd parties and obtains additional claim information needed.   Third parties consist of agents, beneficiaries, funeral homes, coroners, medical providers and police departments.
• Updates system notes with claim progress.
• Orders and reviews medical information.
• Responsible for claim movement and progression.
• Maintains production data and must meet the production quota set by the department.
• Other duties; as assigned by the supervisor.

Required Skills:

• Must be PC/Windows literate and posses a working knowledge of MS Office (Outlook, Excel and Word).
• Strong communication skills.
• Detail oriented.
• Ability to work in a fast paced environment.
• Problem solving skills.

Physical Requirements; While performing the duties of the job, the employee is regularly required to sit for extended lengths of time. The employee is frequently required to reach with hands and arms, occasionally required to stand and walk, occasionally lift and or move up to 25 lbs.

• Must be PC/Windows literate and posses a working knowledge of MS Office (Outlook, Excel and Word).
• Strong communication skills.
• Detail oriented.
• Ability to work in a fast paced environment.
• Problem solving skills.

All your information will be kept confidential according to EEO guidelines.