Senior Claims Analyst

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Dearborn Group

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Dearborn Group is the trade name for Dearborn Life Insurance Company. Since 1969, we have been providing ancillary benefits to employer groups across the country. Our suite of employer-paid and voluntary insurance solutions—including life, short- and long-term disability, vision, critical illness, and accident insurance—creates a comprehensive benefits package that offers employers, their employees, and their families complete peace of mind.

📋 Description

• Perform claim administrative and technical tasks supporting a Claim Unit, vendor staff, Claims Team, and internal departments • Accurately adjudicate and process medical, dental, vision, and related claims • Handle related correspondence and electronic inquiries for assigned groups • Handle claims and inquiries according to plan documents, processing guidelines, and turnaround times • Advise team members on claim processing procedures • Secure and analyze life and disability claim information • Make life and disability benefit determinations according to policy provisions and state and federal laws • Calculate benefit payments and communicate decisions on new and continuing claims • Provide responsive and caring customer service • Complete tasks under general management supervision

🎯 Requirements

• High School diploma or GED equivalent • 3 years prior medical claim processing experience • Minimum three-years life and/or disability claim administration experience for the Life & Disability role • Ability to work in a fast-paced, customer-centric, production-driven environment • Excellent verbal and written communication skills • Ability to work effectively with employees/members, providers, clients, Client Managers, and staff at differing levels • Demonstrated critical thinking and ability to carry out oral, written, or diagrammed instructions • Flexible and open to continued process improvements • Self-directed and able to work with minimal supervision • Good leadership, organizational, and interpersonal skills • Ability to handle complex situations and reach resolution • Ability to analyze and interpret documents and Summary Plan Descriptions (SPDs) • Ability to adapt to various system platforms and effectively use MS Excel and Word • Strong investigation, analytical, organizational, math, decision-making, and attention-to-detail skills • Ability to work in a deadline-driven, fast-paced environment • Self-motivated with high learning agility • Strong time management skills to prioritize workload and manage and follow up on numerous tasks • Capable of making decisions independently or with minimal supervision • Ability to cope with change and shift gears in a dynamic environment • Strong commitment to teamwork and collaborative work • Effective use of personal computers and related software • Proficiency in Word, Excel, and Outlook; Access preferred • Understanding of medical terminology preferred • Health Insurance/Third Party Administrator experience preferred

🏖️ Benefits

• Curated development plans that foster growth and promote rewarding, fulfilling careers • Health and wellness benefits • 401(k) savings plan • Pension plan • Paid time off • Paid parental leave • Disability insurance • Supplemental life insurance • Employee assistance program • Paid holidays • Tuition reimbursement • Other incentives • Annual incentive bonus plan