Claims Adjudicator

National Guardian Life Insurance Company•Madison, WI

8d•Hybrid

About The Position

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.

Requirements

Intermediate knowledge of NGL and acquisition products and procedures
Intermediate communication skills--oral and written
General PC and office machine knowledge
Typing skills of at least 45 words per minute and 5500 keystrokes per hour alphanumeric
Knowledge of basic accounting skills
Ability to work in a team environment
Organized and detail oriented
Ability to quickly search the Internet and other databases
Minimum: High School or GED
One year claims processing experience or equivalent business experience.

Nice To Haves

Preferred: Other
LOMA Level I Certificate
LOMA ACS
Wisconsin Preneed Certification
Two years customer service or insurance/financial experience preferred.

Responsibilities

Accurately adjudicate claims within stated service goals.
Follow established written processing procedures
Verify proper forms are received according to state regulation
Accurately enter and process:
Whole life
Term Life
Universal life & Interest sensitive
Acquisition Preneed
Final Expense
Preneed
Trust claims including Tru Trust, NGL Funeral Expense Trust, and NGL Estate Planning Trust
Preneed Texas including accurate reconciliation and file documentation verification.
Annuities
Contestable claims including referring claims to Underwriting as needed.
Rider claims including accidental death, child/family rider, and spouse rider.
Accurately calculate cost basis on basic annuity claims
Follow-up timely on all claims in writing within state regulated time frames
Provide phone support for all claims related calls and letter correspondence
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
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 insure sufficient team coverage
Help ensure that team standards and goals are maintained
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
Accurately research insured status
Follow established written processing procedures
Search databases to confirm Insured status
Update spreadsheets and document appropriately
Complete assigned projects, tasks, and/or milestones by agreed upon due dates including performing other related work as requested or required

Benefits

20 days of Paid Time Off growing to 25 days after 5 years
11 Paid Holidays (10 company holidays and 1 personal holiday of your choice)
Health care, dental and vision plans
Up to $1,500 (Family) or $1,000 (Single) annually towards a Health Savings Account
Annual bonus based on company performance
Paid Parental Leave
401(k) match up to 9%
Paid Sabbatical after 8 years
Paid Volunteer Time
Education Assistance Program
Employee Recognition Program