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WoodmenLife is a different kind of life insurance company: we're not-for-profit, and we exist to benefit our members through every stage of life.  We are committed to family, community, and country, and our associates can participate in a variety of fun, social, and volunteer activities.  WoodmenLife offers insurance, annuities, mutual funds, and 529 College Savings Plans.

WoodmenLife embraces diversity and works hard to provide a quality, team-oriented work environment.  Dedicated to excellence, we offer a variety of opportunities for personal and professional growth, in an effort to realize the full creative potential of all associates.

Explore all that WoodmenLife has to offer at thisiswoodmenlife.com.

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Life Claims Examiner*

 
Located In:  Omaha, NE
Zipcode:  68102
Date Posted: 
Date Expires: 
Requisition:  2262
Department:  Life Claims
Job Type:  Full-time Employee
Shift: 
Custom
Occupational Category:  43-9041.01 Insurance Claims Clerks
 

Great Culture, Great People, Great Company

If you’re looking for a company that’s big enough to have exciting and challenging business opportunities, yet small enough to make a personal impact – WoodmenLife may be the place for you.

We’ve been a fixture in downtown Omaha over 125 years, and we promote a family-first environment with flexible work schedules, a team-oriented atmosphere, and a culture that encourages personal and professional growth, knowledge and community involvement.

As a not-for-profit, WoodmenLife is a different kind of insurance company. We give back revenues to our members, not investors. We’ve been around for more than a century because we’ve always kept our promises. Through recessions and wars, we’ve remained stable and reliable.

If you want to be part of an organization where you’re not just an employee – you’re a valued member of the family – WoodmenLife is the place for you!

  

 

*Will fill at level commensurate with experience.

 

POSITION PURPOSE:

Secure and analyze claim information for approval or denial of life claims. Makes claims decisions in accordance with the terms of the contract.  Performs detailed analysis and documentation of claim data to direct effective outcome and to meet risk management, regulatory requirements, and in accordance with WoodmenLifes policies and practices.  Pay all death claims on life and annuity certificates.               

ESSENTIAL JOB FUNCTIONS:

  • Adheres to Core Operation’s Behavioral Standards including focusing on solutions, being open to feedback and dialogue, taking initiative, and be involved and accountable
  • Meets expectations for attendance and punctuality in accordance with the expectations established by your supervisor and WoodmenLife policy.
  • Performs other duties as assigned by management.

Level I

  • Indexes all incoming mail and faxed documents for Claims by entering the document type for each piece of mail received.
  • Updates the claim registers, builds tracking (wipr) files and distributes work to the section. 
  • Receives death notice through email or AWD. If no date of death is provided researches claims so that the computer system can be properly documented. Reviews deceased product portfolio to determine how many certificates are in force and evaluates other relationships the deceased may have to other certificates.
  • Makes calls to Funeral Homes verifying pertinent information in order to process claims with face amounts that qualify as “quick” claims.
  • Upon demonstration of required skills and competencies, Independent claim approval limit up to $10,000. Claims up to $25,000 are approved by Senior Claims Examiners or Level II and III Claims Examiner.
  • Updates all required fields of AWD form to systematically code certificate as “deceased”. All death claim coding needs completed the same day as received.
  • Notifies different associates of death by email to include Group Benefits, Sales Force, and Home Office associates to make changes controller changes or needed Transfer of Control.

Level II

  • Examines death claims on life insurance certificates. Reviews the application file for beneficiary designation and confirmation of insurance.  Reviews the claim forms, certified death certificate and any additional documentation to assure that a valid death has occurred and the correct beneficiary has made claim for the proceeds. Reviews the beneficiary designated and determines if the beneficiary is eligible for payment.  Factors that may influence this would be: beneficiary pre-deceased the member, beneficiary died after the member, payment is to be made in accordance with the Constitution and Laws of WoodmenLife, ex-spouse, funeral home assignment, minor child or incompetent adult (letters of guardianship or conservatorship of the estate, collateral assignment (release of assignment or statement of indebtedness.) 
  • Communicates with claimants, funeral homes, sales representatives and other departments to resolve complaints or discuss matters relevant to effective claims administration. 
  • Reviews the cause and manner of death. Assigns the the most appropriate mortality code to the claim and codes on the claim system. Additional review is required if cause of death is other than Natural Causes.
  • Determines if adjustments are needed to the benefit amounts itemized by the system.  Claim amounts may need adjusted for the following reasons:  the date of death crosses the last anniversary of the certificate and refunds are granted on the certificate must be adjusted. The member’s date of birth is different and requires an adjustment be made to the face amount of the insurance. The interest rate payable for the claim must be manually calculated to comply with state regulations.
  • At time of payment, reviews state requirements to determine if WoodmenLife is required to perform a data match of its beneficiaries against a Child Support Division database in an attempt to intercept payments to a parent who may be in default of their child support obligations.
  • Upon demonstration of required skills and competencies, Independent claim approval limit up to $25,000. Claims $25,001 and up are approved by Senior Claims Examiners or a Level III Claims Examiner.
  • Continually reviews and analyzes the workflow to provide efficient service and meet service level goals.  Makes recommendations for changes that enhance the process and improve customer service.

QUALIFICATIONS:

  • High school diploma or equivalent education/work experience.
  • Demonstrates knowledge of WoodmenLife products and knowledge of Core Operations systems, policies and procedures.
  • Demonstrates in-depth problem solving capabilities, including ability to detect discrepancies, trends and efficiencies needed. 
  • Ability to understand and then clearly communicate information and answers to Home Office associates and external customers.  
  • Ability to provide and receive constructive feedback.
  • Ability to maintain confidentiality, sensitivity and professionalism.
  • Ability to work well with others in a team environment.
  • Ability to work with a high level of concentration and attention to detail.

Level I and Level II

  • Knowledge of GLBA along with other state and federal regulations.

 

 

WoodmenLife offers a competitive compensation package and a comprehensive benefits package. As part of WoodmenLife’s employment process, candidates will be required to complete a criminal background check, credit check (where required for position), Fingerprint check (where required for position), drug screen and reference checks. Any offer of employment will be contingent upon successfully passing the above.

WoodmenLife is committed to excellence in diversity by creating an inclusive work environment that values and respects all individuals. We welcome and embrace associates, regardless of background and beliefs. WoodmenLife respects every associate’s unique perspective and contribution. We are committed to creating an inclusive environment that values differences, and creates opportunities for growth, leadership and service. This commitment includes providing equal opportunity in recruitment, employment and promotion, training and community outreach. WoodmenLife is also dedicated to strengthening the communities in which its employees live.

APPLICANTS WITH DISABILITIES SHOULD ADVISE THE HUMAN RESOURCES DEPARTMENT AT THE TIME OF APPLICATION IF SPECIAL ACCOMMODATIONS ARE NEEDED.

 Woodmen of the World Life Insurance Society (WoodmenLife) is an equal opportunity employer. 

What's in Your Future

WoodmenLife is big enough to have exciting and challenging business opportunities, yet you'll never be just another face in the crowd.  Find out for yourself at thisiswoodmenlife.com.

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