Claims Adjuster I - Tinicum Township - job 676544

CNO Financial Group, Inc.

Date: 04/08/2021

City: Tinicum Township, Pennsylvania

Employment type: Full-time

This position is responsible for providing claim service in a manner that promotes integrity and customer satisfaction. Responsible for evaluation, adjudication and processing in a timely, cost effective manner that is compliant with state regulations and company policies. Responsible for identifying opportunities for process improvements and implementing changes once identified.



Primary Duties & Responsibilities:




  • Reviews policy provisions and medical facts, along with any other documentation as needed, to make an appropriate claim decision in accordance with statutory and company requirements.


  • Calculates payment of benefits due and processes claims in the appropriate admin system.


  • Communicates with beneficiaries, policyholders and/or agents to request additional documentation, or to advise them of procedures necessary to complete claim adjudication and to communicate claim decisions.


  • Documents claim file of all actions taken.


  • Makes recommendations for process improvements.


  • Consults with other areas of the company as the work demands (i.e. Underwriting, SIU, PHS, Legal, etc.).


  • Performs all other duties as assigned.



Core Skills and Knowledge:




  • Ability to provide prompt and high quality customer service to our policyholders, beneficiaries and agents.


  • Basic knowledge of claims administrative procedures.


  • Basic knowledge of insurance products.


  • Good critical thinking abilities


  • Basic ability to prioritize


  • Basic ability to multi-task and adapt to an ever changing environment.


  • Good knowledge of Microsoft Word, Excel and Outlook.


  • Good ability to effectively communicate, both verbally and through written correspondence to our customer.


  • Basic knowledge of medical terminology


  • Good decision-making abilities.


  • Good interpersonal and organizational skills.



Requirements:




  • Bachelor degree (preferred) or equivalent work experience.


  • Some insurance industry or financial services customer service experience with 1 year claim experience preferred.





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