Symetra Financial

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Waiver of Premium Claims Specialist

at Symetra Financial

Posted: 10/24/2017
Job Reference #: 5000255511606
Categories: Insurance
Keywords: insurance

Job Description

Job Description

Symetra is a dynamic and growing financial services company with 60 years of experience and customers nationwide.  In our daily work of delivering retirement, employee benefits, and life insurance products, we're guided by the principles of VALUE, TRANSPARENCY AND SUSTAINABILITY.  That means we provide products and services people need at a competitive price, we communicate clearly and honestly so people understand what they're getting, and we build products that stand the test of time.  We work hard and do what's right for our customers, communities and employees.  Join our team and share in our success as we work toward becoming the next national player in our industry.

Symetra has a new opportunity for a group life waiver of premium claim specialist.  This person will be responsible for timely adjudication of life waiver of premium claims, including the ongoing annual reviews to verify continued eligibility. Strong desire to provide world class service to both internal and external customers.  
 
Specific responsibilities include:
  • Reviews, investigates and determines eligibility pursuant to policy provisions.
  • Requires ability to appropriately interpret and apply contract provisions.
  • Consults with manager regarding potential referrals to Legal Department and medical resources when needed.
  • Maintains claim records and documents in a manner defensible in court.
  • Provides customer service and communicates claim decisions to policyholders and claimants.
  • Includes coaching the policyholder on proper policy administration when needed.
  • Assesses physical capacity in accordance with diagnostic and medical record evidence and manages risk with clinical medical review.
  • Assesses LTD claim for claim information using our integrated platform Conducts annual medical update and claim reassessment as appropriate.
  • Provides conversion rights at benefit reduction and benefit termination.

Job Requirements

  • Medical background a plus. College degree is preferred, but not required.
  • Minimum 3-5 years of work related experience.
  • Understanding of HIPAA and Privacy regulations, as well as ERISA.
  • High level attention to detail and accuracy.
  • Ability to identify priorities, manage time well and work under pressure to meet or exceed performance expectations.
  • Strong communication skills, both verbal and written.
  • Supports continuous process improvement and total performance management culture.
  • Ability to use multiple mainframe applications simultaneously and easily learn new systems.