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Claims Examiner in Addison, TX at NTA Life

Date Posted: 4/6/2018

Job Snapshot

Job Description

Position Summary

The Claims Examiner is responsible for maintaining an average of 80% productivity with an error rate of 5% or less. 

Essential Functions

  • Reviews claims submitted to determine type and amount of claims to be paid.
  • Determine the in-force status of the policy.
  • Compare the provisions of the policy and applicable laws with submitted information to accurately adjudicate the claim.
  • Communicates with policyholders, beneficiaries, and/or health care providers concerning claim handling, claim denials, claim payments and policy contract provisions in a caring, courteous, empathetic, and professional manner.
  • Request and evaluate medical and/or other necessary information relevant to the claim analysis.
  • Perform other duties as assigned.

Job Specific Skills

  • Active Listening - Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
  • Critical Thinking - Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
  • Time Management - Managing one's own time and the time of others.
  • Writing - Communicating effectively in writing as appropriate for the needs of the audience.
  • Reading Comprehension - Understanding written sentences and paragraphs in work related documents.
  • Speaking - Talking to others to convey information effectively.
  • Written Expression - The ability to communicate information and ideas in writing so others will understand.
  • Originality - The ability to come up with unusual or clever ideas about a given topic or situation, or to develop creative ways to solve a problem.
  • Written Comprehension - The ability to read and understand information and ideas presented in writing.
  • Oral Expression - The ability to communicate information and ideas in speaking so others will understand.
  • Oral Comprehension - The ability to listen to and understand information and ideas presented through spoken words and sentences

Experience and Education

  • Requires a high school diploma or GED. Bachelors' degree preferred
  • 2 or more years’ experience processing supplemental insurance (Accident, Heart, Cancer, Disability) preferred
  • Knowledge of insurance products preferred

Job Requirements

Job Requirements  

  • Some LOMA or AHIP classes or a willingness to take LOMA or AHIP classes
  • Ability to type 40 words per minute minimum
  • Must possess knowledge of Microsoft office, Word, Excel, etc.
  • Strong written and verbal communication skills
  • Must have excellent organizational skills
  • Must be able to work efficiently and effectively with all departments
  • Demonstrates the characteristics of courtesy, honesty and integrity necessary to meet customer

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