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Insurance Claims Examiner

Insurance Claims Examiner/Customer Service Representative

WOS partners with a Fortune 500 leader to hire Veterans, Military Spouses, and Guard/Reserve members. With a global footprint, our partner provides customers with a variety of products and services, including life insurance, annuities, retirement-related services, mutual funds and investment management. They strive to create long-term value for their stakeholders through strong business fundamentals, consistent with their mission guided by their vision and directed by their company's core values.

Candidate Profile:

  • Military veteran with service past 9/11/2001 (Active Duty, National Guard or Reserve) OR
  • Spouse of a military veteran with service past 9/11/2001 (Active Duty, National Guard or Reserve)
  • Veterans must have an Honorable Discharge
  • High School Diploma or GED
  • Availability to work full-time

Job Description

WOS provides a pathway to meaningful career opportunities for Veterans and Military Spouses (see below). In this role, you will deliver benefit experiences that help protect financial wellness, making a meaningful impact in the lives of our customers and our communities. In this role, you will provide exceptional customer service by managing your case load in a timely, accurate, and efficient manner.

This position is accountable for analyzing claims, following processes & procedures associated with handling and paying claims, calculating accurate benefit amounts, information gathering and accurately documenting, explaining benefit coverage, documenting. Position includes servicing inbound and outbound calls.

Responsibilities:

  • Provide information to, and gather information from: policy holders, parents, spouses, beneficiaries and the branches of service.
  • Receive, evaluate and answer customer inquiries which are predominately routine but may require deviation from standard screens, scripts and procedures
  • Analyze information, apply root cause problem solving techniques, accurate data collection and entry into various computerized systems
  • Utilizes judgment and assessing risk when rendering claim decisions
  • Use computerized system for tracking, information gathering, providing information, referrals, routine transactions and/or troubleshooting
  • Knowledge and understanding of policies and procedures to make appropriate claim decisions
  • Answer product, account, policy and service inquiries, resolve problems, and promote products and services by responding verbally and/or in writing
  • Assess needs and suggest/promote alternative products or services
  • Handle most calls and claims processing transactions independently and escalate properly when appropriate
  • Performs other duties as assigned

Requirements:

  • Typically, 1-3 years of directly related customer service experience and/or well-developed claim experience. Financial or banking background preferred
  • Attention to detail is critical to this role
  • Ability to learn and retain a large amount of technical information in a relatively short period of time
  • College degree or equivalent business/military experience is preferred
  • Strong people skills with an ability to think like the customer
  • A passion for delivering top quality service
  • Proven record of dependability. Punctual and reliable attendance is critical to the success of a fast moving, claims processing role
  • Customer Service knowledge is a plus with a focus on MAGIC principles
  • Receptivity to details and frequent performance feedback
  • Proficiency with a keyboard and window-based applications, including the Internet
  • Proven self-motivation skills
  • Excellent oral and written communication skills
  • Ability to excel in a team environment, as well as work independently
  • Excellent organization and prioritization skills

WOS provides 10-12 weeks of paid training and will assist you in making the transition to Full-Time

Once hired, the role includes:

  • Paid training on company products, systems and procedures.
  • Continuing education credentials.
  • Ongoing coaching and career development, individual and group coaching sessions and opportunities to participate in mentorship and personal development programs.

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About WOS

Founded in 2005, Workforce Opportunity Services (WOS) is a leading 501(c)(3) nonprofit committed to developing the skills of untapped talent from underserved and veteran communities through partnerships with organizations dedicated to diversifying their workforce. Utilizing a scientifically-based model derived from research conducted at Columbia University, we recruit, educate, train, and place high-potential candidates with leading organizations around the world. To date, WOS has served 3,800+ individuals through partnerships with more than 60 corporations in 40+ locations worldwide. For more information, visit wforce.org