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Life & Waiver Examiner

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Job Details
Job Order Number
8058969
Company Name
Health Care Service Corporation
Physical Address
Company Worksite
Lombard, IL 60148
Job Description

Job ID:JMS-1040862
Description:

Dearborn – (HCSC Subsidiary)

Job Purpose:

Under supervision, this position is responsible for examining and processing claim types including life, waiver of premium, critical illness, accident insurance claims and other claim types for various policies. May perform a variety of related duties to discuss / resolve claim issues and provide customer service.job code, grade, salary plan, soc code

Required Job Qualifications:

  • Bachelor degree or 4 years of business experience.
  • 2 years of claims experience, proficient in processing life and waiver of premium claims.
  • Problem solving and research skills.
  • PC proficiency to include Word and Excel.
  • Math aptitude, critical thinking skills, and analytical skills.
  • Customer Service experience.
  • Organizational skills.
  • Knowledge of state regulations, statutes and ERISA in reference to Life and waiver of premiums.
  • Experience handling multiple tasks and making priorities.
  • Clear and concise verbal and written communication skills.
  • Proficient in the following: Correspondence, Medical Records Review, Misrepresentation Investigation, Pre-Existing Investigation, Evidence of Insurability Review, Benefit Entitlement Review, Financial Accuracy, ERISA Guidelines, MAR Requirements, State Regulations, Contract Language, Company Financial Liability.
  • Experience in the following core systems: ECM, STAR (Claim System), Genelco/GIAS, Siebel, UTS, Casetrak, Docsql, Benefits Manager, and ImagePlus.
  • Experience in processing any of the following two (2) claim types: Critical Illness/Specified Disease, Wellness benefit, Accidental Insurance, GAP, Permanent and Total Disability (PTD benefits, Accidental Death and Dismemberment, Stand Alone Accidental Death and Dismemberment benefits, Permanent and Total Disability (PTD), and Accelerated Death Benefits.

Preferred Job Qualifications:

  • LOMA courses.
  • Knowledge of state regulations, statutes, and ERISA in reference to A D & D insurance.

This position will be located in Lombard, IL or Richardson, TX.

LI-Post*

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Requirements:
Expertise

  • Claims & Customer Service

Claims & Customer Service

Job Type

  • Full-Time Regular

Full-Time Regular

Location

  • TX – Richardson, IL – Lombard

TX – Richardson, IL – Lombard

BCBSTX complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.


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