Quality Control Reviewer III

Responsibilities:

• ·         Conduct audit of life insurance and accidental death and dismemberment claims to measure timeliness and accuracy

• ·         Handle and resolve complex questions and issues, pended life insurance claims, inquiries and appeals

• ·         Communicate, in person, by telephone or in writing, with beneficiaries and their representatives, attorneys, employers, funeral homes, health care providers, and other professional regarding life insurance claims

• ·         Work closely with various departments to address eligibility, pension or other issues affecting life claim resolution

• ·         Assist with claims referrals from life claims processors as needed

• ·         Delegate staff assignments and assist in training and retraining of staff

• ·         Troubleshoot problems and assist staff in resolving difficult issues, answer questions regarding policies and procedures

• ·         Create and maintain various production, statistical, financial, and audit reports

• ·         Assist life insurance staff members with difficult or complex calls, and walk in contacts

• ·         Monitor system performance related to life claims; identify trends, review results, and provide recommendations for improvements in training, controls and procedures or system updates

• ·         Assist hotline support as needed

• ·         Handle assignments of burial plots using plot grids and maps

• ·         Perform additional duties as assigned by management

Qualifications:

• ·         High school diploma or GED required, some college or degree preferred

• ·         Minimum two (2) years experience as a life insurance approver processing group life and accidental death required

• ·         Comprehensive knowledge of NBF, GNY and home care funds life insurance eligibility, benefits and rules for extended or limited continuation of benefits required

• ·         Experience working in MS Word and Excel preferred

• ·         Effective communications skills both written and oral required

• ·         Good interpersonal skills, including ability to communicate with the staff on a professional level

• ·         Ability to work under pressure and independently

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