At Legal & General America, we aim to make a positive difference in the lives of our customers, partners, colleagues, and the communities in which they live. As a recognized market leader of term life insurance, we’re working to transform our business through innovation and technology to provide products and solutions that help American families secure their financial futures.

We are a future-focused company, passionate about what we do and how we do it. This means working with pace and energy to reach our goals, and challenging ourselves to achieve more. We strive to create a unique environment where balance between work and life is possible. Our employees' passion, dedication and hard work, as well as our career development opportunities, benefits, and employee activities contribute to our positive workplace culture.

The Claims Representative I is responsible for the set up, research, review and processing of non-contestable claims within established productivity and quality standards. Complete all other claims related tasks to meet or exceed pre-defined productivity and quality standards. Complete other administrative duties and projects as directed by management.

Responsibilities:

II. Essential Responsibilities

• Set up, research, review and process non-contestable claims within established productivity and quality standards.
• Review company records to confirm insurance coverage.
• Review all beneficiary and title changes and collateral assignments for correctness and generate appropriate correspondence in accordance with state insurance regulations requesting appropriate claim requirements.
• Open up claims files according to departmental procedure. Notify reinsurer of death or waiver claim.
• Review file to determine eligibility for accelerated death claims processing and request appropriate documentation.
• Evaluate documentation submitted for processing of claim and confirm its eligibility for payment utilizing knowledge of estates, trusts, minor beneficiary requirements, divorce statutes and other regulatory requirements. If documentation is insufficient, request correct or additional requirements needed in order to give the claim further consideration.
• Correspond and communicate with claimants, attorneys, agents, reinsurers and other company departmental staff to discuss and/or resolve matters relevant to effective claims administration, including competing claim issues.
• Review progress and status of pending claims with management and discuss problems and suggested solutions.
• Follow up on all pending non-contestable claims within established regulatory requirements.
• Follow established escheat procedures on pending claims review and run Accurint or other public records database searches as needed.
• Process claim on administrative systems using the appropriate Post Mortem Interest statutes, dividend calculations and contract provisions to reflect settlement or payment of claim to the appropriate party.
• Send disbursement correspondence and document file reflecting interest and payment amount.
• Document all activity to support claim file
• Answer phones and respond to correspondence pertaining to the initial notification of death, waiver and health claims.
• Process mail received on a daily basis; to include proper recording of mail received, proper identification of items received and proper indexing of images to the correct policy.
• Keep abreast of “red flags” for fraud and identify potential issues to prevent payment of fraudulent claims including foreign death requirements.
• Complete form 712’s as needed.
• As required, bill reinsurer for their share of the liability and update appropriate system. Communicate with reinsurers as needed on problem cases.
• Review and process 3rd party invoices for payment.
• Keep abreast of claims related regulatory requirements.
• Operate in a team environment and support other team members to enhance overall productivity.
• Complete all other projects and tasks as assigned by management.

Qualifications:

Education

High School diploma or equivalent
Some college preferred

Experience/Knowledge

1-2 years of experience in life or health claims or customer service/administrative position
preferred.

Skills

Typing 35 WPM
Proficiency in spreadsheet and word processing software
Detail oriented
Strong organization skills
Outstanding verbal and written communication skills
Superior customer service skills
Good problem solving and negotiation skills
Strong product knowledge and proficiency in understanding basic contract language
Good analytical skills
Ability to work in a fast-paced environment
Flexible with regard to work hours and overtime
Knowledge of Microsoft Office

What’s in it for you?

The expected hiring compensation range for this position is $45,800-$59,525 annually.

The total compensation package for this position may include other elements, such as a sign-on bonus, long term incentives, and annual bonuses. This role is eligible to participate in the Legal & General America Annual Incentive Plan. The current target payment for the position is 3% of base salary, modified for corporate and individual performance. Bonuses are pro-rated based on start date. This role has 10 vacation days and 10 sick days that are accrued on a bi-weekly basis. Employees also have 9 paid holidays throughout the calendar year.

We have a competitive compensation and benefits package focused on your overall wellbeing. Employee benefits include health, life, and dental insurance; 401K with company match up to 6% as well as a pension package; generous time off; and wellbeing initiatives throughout the year (we like doing fun stuff). We’re big on professional development and we’ll support and mentor you in your career progression and expect you to help us pay it forward by helping us develop tomorrow's leaders and growth-focused professionals. We value our teams and our communities and believe in giving back. Enjoy time off to volunteer for those causes that matter most to you!

If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors. The Company reserves the right to change benefits plans at any time.

We are an equal opportunity employer and value diversity at our company. We do not discriminate based on race, religion, color, national origin, sex, gender, gender expression, sexual orientation, age, marital status, veteran status, or disability status. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, perform essential job functions, and receive other benefits and privileges of employment. Please contact us to request accommodation.- 

Looking for more jobs near me. Find your favorite job now by visiting our jobs page.