Claims Examiner

The Claims Examiner processes incontestable claims and contestable claims. Performs robust treaty liability reviews, reviews claims for accuracy, calculates interest as needed, and processes payment for approved claims. Recovers less complex retrocession claim payments.

Responsibilities

• Reviews, verifies, and confirms high dollar incontestable claims, and low dollar contestable claims.

• Verifies that the cession claimed was properly ceded to RGA Re and was properly established on RGA Re administration system. Takes steps to resolve questions that arise from these claims with assistance as needed.

• Refers questionable, contestable or early death claims to underwriting, medical and/or legal departments. Summarizes all issues, with a suggested resolution and refers to department manager or vice president for final resolution.

• Recovers less complex retrocession claim payments that flow through the administration system under an automated program. Assures that recoverable on retroceded claims are paid to RGA on a timely basis.

• May advise client on claim investigation activities as assigned.

• Processes payment for approved claims via ACH, wire transfers or check.

• Recognizes early death claims to be escalated

Requirements

Education and Experience

Required:

• Associate Degree or equivalent experience

• 2-4 years claims experience

Preferred:

• Prior life claims experience

• Progress toward FLMI, ALHC or other relevant professional accreditation

Skills and Abilities

Required:

• Basic Microsoft Word Skills

• Intermediate Microsoft Excel Skills

• Basic Microsoft Outlook Skills

• Basic SQL skills

• Basic Query skills

• Basic knowledge of accounting

• Must be flexible and adaptive to change

• Intermediate written and oral communication skills

• Takes initiative and is accountable

• Ability to read and interpret treaty language, and to apply it appropriately

• Must possess Investigative skills

• Ability to multi-task

• Basic goal setting skills

• Intermediate analytical and problem solving skills

• Ability to share and impart knowledge

• Ability to balance detail with departmental goals/objectives

• Ability to work independently

• Ability to work well within a team environment and participate in department projects

Preferred:

• Medical knowledge