Claims Adjudicator - Remote, WI-ONLY (Temporary-6 months)

We are adding a Claims Adjudicator to our team!

Who We Are:

Since 1909, National Guardian Life Insurance Company (NGL) has been one of America’s most successful and highly rated independent life insurance companies. We specialize in a suite of innovative products for life’s journey, giving people the financial stability, careful guidance and peace of mind to lead a life filled with confidence, dignity and grace.

NGL's Core Values – integrity, dependability, collaboration, compassion and growth are a foundation of our company and help to build on the interactions we have with our policyholders, partners, funeral homes and each other. We believe in creating an inclusive, welcoming environment for all where diversity is celebrated, and everyone is encouraged to live their best, most authentic self. We offer Employee Resource Groups for employees to get involved, learn, network, and offer professional and personal development opportunities.

With over 100 years of experience, our passion is to serve people. Learn more.

Work Environment:NGL offers a flexible work environment where employees can work fully remote, hybrid or onsite at our Madison, Wis. office. We support virtual working arrangements in certain states outside of WI.

A Day in the Life:

The Claims Adjudicator is responsible for processing claims, effectively communicating and corresponding with external and internal customers including policyholders, agents, funeral directors, and beneficiaries. Additional responsibilities include processing various types of claims and service requests along with providing phone support accurately within or exceeding existing service goals. In this role, work is performed under general supervision. The position requires the need to conduct additional research and to accurately document all findings as deemed appropriate.

Primary Responsibilities:

Adjudicate Claims

• Accurately adjudicate a minimum of 25 claims per day within stated service goals.
• Follow established written processing procedures.
• Verify proper forms are received according to state regulation.
• Accurately enter and process variety of life insurance, trust and annuity claims.
• Accurately calculate cost basis on basic annuity claims
• Follow-up timely on all claims in writing within state regulated time frames

Customer Service

• Ability to effectively communicate, with empathy when appropriate, to our customers verbally, in writing, and via email.
• Ability to actively listen and appropriately respond to others.
• Provide phone support for claims related calls while maintaining team service goals.
• Contact agents, funeral homes beneficiaries, and other customers to obtain missing information when needed.
• Prepare proper correspondence for all steps in the claim process and as needed to respond to customer inquires.

Collaboration and Teamwork

• Effectively and actively collaborate with others and work towards shared goals.
• Ability and willingness to work with others in a team environment.
• Participate in group decision making, listening, and responding constructively to others.
• Offer help to teammates when the need arises.
• Manage and adjust personal time off, breaks, and lunches to ensure sufficient team coverage.
• Help ensure that team standards and goals are maintained.

Claims Resolution

• Evaluate and resolve basic to moderately complex claims-related issues.
• Transfer knowledge from one process and apply it to another like process regarding common situations.
• Able to gather most needed data and petition input to help recognize the symptoms and root causes of distinct problems.
• Examine defined issues with ambiguous causes.
• Suggest alternative approaches that meet the needs or the organization, the situation, and those involved.
• Resolve difficulties and escalate issues with suggestions for additional inquiry.

Research and Documentation

• Accurately research insured status.
• Follow established written processing procedures.
• Search databases to confirm Insured status.
• Update spreadsheets and document appropriately

Additional Duties

• Complete assigned projects, tasks, and/or milestones by agreed upon due dates including performing other related work as requested or required.

Essential to Your Success:

• Excellent written and verbal communication skills
• Ability to draft professional written communication using correct grammar, punctuation, and spelling
• Strong attention to detail with a high level of accuracy
• Basic computer skills with the ability to perform tasks and work in Microsoft Word, Outlook and Excel
• Knowledge of basic accounting skills
• Ability to work independently and in a team environment
• Ability to learn quickly and adeptly handle issues that arise even when unfamiliar
• Effective and efficient organizational skills and ability to manage competing demands and tight deadlines
• Typing skills of a minimum of 45 words per minute

Education Requirements:

• Minimum: High School or GED
• Preferred: Other
• LOMA Level I Certificate
• LOMA ACS

Wisconsin Preneed Certification

Years of Experience:

• One year claims processing experience or equivalent business experience.
• Two years customer service or insurance/financial experience preferred.

NGL is committed to creating a diverse environment and is an Equal Opportunity Employer. Qualified applicants will be considered for employment without regard to race, color, creed, religion, national origin, ancestry, citizenship status, age, disability, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable state or local law, genetic information, or any other characteristic protected by applicable federal, state, or local laws.

NGL is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact .

Originally posted on Himalayas