Group Claims Support Specialist

Summary

Join Horace Mann as a Group Claims Support Specialist and contribute to a supportive team environment. You will play a vital role in assisting Group Claims Examiners by gathering, verifying, and entering claim information. Responsibilities include reviewing and managing claims across various lines of Group Insurance, ensuring compliance with regulations. You will accurately enter data, gather necessary documentation, maintain organized files, and provide excellent client service. The ideal candidate possesses strong organizational skills, attention to detail, and effective communication abilities. This position offers a competitive salary and the opportunity to work for a reputable company committed to supporting educators.

Requirements

• High School diploma or GED required
• Bachelor’s degree in a related field or equivalent work experience
• Strong organizational and time management skills
• Excellent attention to detail and accuracy
• Effective communication and interpersonal abilities

Responsibilities

• Responsible for the review and management of claims across all lines of Group Insurance, including but not limited to: Short Term Disability, Long Term Disability, Waiver of Premium, and Life claims
• Review, analyze, and process group claims in accordance with company policies and procedures, ensuring all claims are processed in compliance with regulatory requirements
• Accurately enter claims data into the claims management system
• Gather and verify necessary documentation and information from clients and internal departments
• Maintain comprehensive and organized claim files
• Provide prompt and courteous service by addressing client inquiries and concerns
• Communicate effectively with clients, policyholders, and beneficiaries
• Conduct thorough review to verify claim validity
• Identify and report potential fraudulent claims
• Stay current on changes in industry regulations and standards
• Work closely with other departments, such as underwriting, legal, and compliance teams, to resolve complex claims
• Coordinate with external parties, such as medical professionals and service providers, as needed
• Analyze claims data to identify trends and patterns
• Prepare reports and summaries for management review
• Utilize claims management software and other tools to streamline claim processing
• Address and resolve any discrepancies or issues that arise during the claims process
• Develop and implement solutions to improve claim handling efficiency
• Build and maintain strong relationships with key clients and stakeholders, ensuring a positive client experience throughout the claims process
• Prepare and organize claim files, ensuring all necessary documentation is complete and accurately filed
• Maintain accurate and up-to-date records of all claims-related activities
• Scan, upload, and manage electronic and physical documents related to claims
• Generate standard reports and summaries for the claims team and management
• Respond to basic inquiries from policyholders, beneficiaries, and clients regarding the status of their claims
• Assist the Group Claims Department with new claims set-up, filing, archiving, and ordering archived claim files, job requests, copying, sending out letters, and participating in special projects as necessary
• Assist with incoming mail review through regular USPS or electronic mail from Data Dimensions. Evaluate disability applications for thoroughness; request additional documentation from the applicant or employer, as necessary. Route electronic mail to the designated Claim Specialists
• Index different document types that come into the Group Claims Department by mail, electronic mail, faxes, and email. Set up initial disability claim records in our paperless claims storage system
• Set up invoices for payment of expenses from vendors and medical providers
• Review Paid Up Life applications and enter the new applications in Microsoft Access
• Update PolicyPro to reflect Employer and Contact person changes
• Process and mail FICA billings, commission checks, and other reports monthly

Preferred Qualifications

• Experience in an administrative or support role within the insurance or financial services industry preferred
• Basic knowledge in Microsoft Office Suite and familiarity with claims management software preferred

Benefits

Pay Range: $18.51 - $29.13/hr